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HOME  NURSING 


•The 


HOME  NURSING 


MODERN  SCIENTIFIC  METHODS  FOR 
THE  CARE  OF  THE  SICK 

2.-2L  QO  5~ 
BY 

EVELEEN    HARRISON 


Wefo  $fork 
THE   MACMILLAN   COMPANY 

LONDON:  MACMILLAN  &  CO.,  LTD. 

1909 

Att  rights  reserved 


COPYRIGHT,  1900, 
BY  THE  MACMILLAN  COMPANY. 


Set  up  and  electrotyped  February,  1900.      Reprinted  May, 
1900;  August,  1905;  April,  1906;  March,  October,  1909. 


NortoooD  Press 

J.  &  Cuihing  &  Co.  —  Berwick  &  Smith 
Norwood  Mass.  U.S.A. 


"Ask  God  to  give  thee  skill 

In  comfort's  art  — 
That  thou  may'st  consecrated  b« 

And  set  apart 
Unto  a  life  of  sympathy. 
For  heavy  is  the  weight  of  ill 

In  every  heart, 
And  comforters  are  needed  much 

Of  Christ-like  touch." 

A.  E.  HAMILTON. 


PREFACE 

THIS  little  work  is  published  in  the  hope 
that  it  will  be  a  help  and  comfort  in  the  home 
life. 

It  is  composed  of  the  simplest  rules  and 
remedies  to  be  used  in  the  care  of  the  sick, 
and  some  general  directions  regarding  the 
nourishment  that  should  be  given,  more  espe- 
cially during  convalescence,  and  always  sub- 
ject to  the  approval  of  the  physician  in  charge 
of  the  case. 

A  few  pages  of  simple  recipes  for  invalid 
cooking  —  which  for  convenient  reference  have 
been  grouped  under  the  headings  of  the  vari- 
ous diseases  in  which  they  will  be  found  most 
useful—  have  been  added,  and  as  they  have 
been  tested  by  actual  experience,  it  is  believed 
that  they  will  be  found  of  real  service. 

There  are  many  cases  of  slight  illness  where 
the  services  of  a  trained  nurse  are  not  required, 
vii 


PEEFACE 

and  also  many  homes  where  that  "expensive 
luxury  "  (as  I  have  heard  her  called)  is  quite 
out  of  reach  of  the  purse  strings,  and  her  place 
has  to  be  supplied  by  the  loving  ministrations 
of  mother,  wife,  or  daughter. 

It  is  for  these  home  nurses  that  I  have  gath- 
ered together  the  suggestions  and  ideas  in  this 
little  book,  with  the  sincere  hope  that  it  will 
prove  of  real  assistance  to  them  in  the  care  of 
the  loved  ones  at  home. 

B.  H. 


CONTENTS 

CHAPTER  I 

PAGB 

How  to  make  a  sick-room  attractive  —  The  best 
way  to  provide  for  light — Heat  —  Ventilation 

—  Comforts  for  the  patient  —  Care  during  con- 
valescence    ........        1 

CHAPTER  II 

Temperature  —  Pulse  —  Respiration  —  The  giving 
of  medicines 30 

CHAPTER  m 

Prevention  and  care  of  coughs  and  colds — Tonsilitis 

—  Grippe  —  Bronchitis  —  Pleurisy  —  Pneumonia 

—  How  to  aid  sleeplessness 44 

CHAPTER  IV 

Baths  in  health  and  sickness  —  Cold  —  Hot  —  Foot 
baths  —  Mustard  baths  —  Sponge  baths  —  Salt 
baths 63 

CHAPTER  V 

Fevers  —  Infection  —  Symptoms  —  Isolation  —  Con- 
tagion —  Nursing  —  Disinfection  ...  79 


CONTENTS 


CHAPTER  VI 


Observation  of  symptoms — Special  care  of  sick 
children  —  Croup  —  Whooping  cough  —  Mumps 
—  Convulsions  —  St.  Vitus'  Dance  .  .  .  104 


CHAPTER  VET 


Dainty  dishes  to  tempt  the  sick  and  how  to  serve 
them  —  Indigestion 120 


CHAPTER 


Poultices  —  Plasters  —  Blisters  —  Oil-silk  jacket — 
Cold  and  hot  applications  —  Counter-irritants  — 
Sprays  and  douches  —  Enemata  ....  143 


CHAPTER  IX 


How  to  prepare  for  a  surgical  operation  at  home  — 
Some  hints  as  to  the  after  care  of  the  patient     .    158 


CHAPTER  X 


Home  emergencies  —  Burns  —  Shock  —  Fainting 
—  Nervous  hysteria  —  Poisoning  —  Sprains  — 
Bruises  or  cuts  —  Hemorrhage  from  the  lungs 
and  nose  —  Sore  eyes —  Earache  —  Toothache  - 
Foreign  bodies  in  the  throat  —  Hiccough  — 
Vomiting  —  Epilepsy — Artificial  respiration  .  171 


CONTENTS  xi 

i 

APPENDIX 

PAGE 

DIET  IN  DISEASE  AND  CONVALESCENCE       .        .  191 

RECIPES  FOR  INVALID  COOKING  :  — 

For  Fevers,  Grippe,  Bronchitis,  Pneumonia        .  208 

For  Rheumatism  and  Gout 211 

For  Diarrhoea  and  Dysentery       ....  216 

For  Indigestion  and  Dyspepsia    ....  218 

For  Pulmonary  Tuberculosis       ....  221 

For  Convalescence 225 


HOME  NURSING 


CHAPTER  I 


Choice  of  room  ^ 

for  the  sick 

The  keynote  of  a  sick-room  is  cheerfulness  ; 
therefore  it  should  be  the  most  attractive  room 
in  the  house,  so  far  as  brightness,  cleanli- 
ness, plenty  of  sunshine,  and  fresh  air  can 
make  it. 

It  is  not  always  possible  to  choose  the  most 

r^          suitable   apartment    for   sickness  ;    as   a   rule, 

^          when  a  member  of  a  family  is  ill,  he  prefers 

to  remain  in  his  own  room.     In  cases  of  infec- 

tious fevers,  however,  it  is  necessary  to  prepare 

^  a  room  in  an  especial  manner,  and  to  isolate 

the  patient  from   the   other   members  of  the 

family.     A  room  on  the  top  floor  is  to  be  pre- 

ferred, or  one  in  an  extension  that  can  easily 

be    shut    off    from    the    other   parts    of    the 

house. 

B  1 


2  HOME  NUKSING 

A  room  without  a  carpet  is  always  best, 
especially  during  fevers  and  severe  surgical 
cases;  but  in  ordinary  attacks  of  illness  it  is 
wiser  not  to  disturb  the  usual  appearance  of 
the  room  more  than  is  absolutely  necessary, 
as  it  might  have  a  depressing  effect  on  the 
patient,  and  give  him  reason  to  fear  that  he 
is  seriously  ill. 

By  the  same  reasoning  a  single  iron  bedstead 
is  best  and  most  convenient  from  the  nurse's 
point  of  view,  but  in  a  simple  case  of  sickness 
it  is  neither  wise  nor  necessary  to  make  a 
change.  Do  not  have  the  room  overloaded 
with  furniture,  —  only  to  be  in  the  way,  and 
to  be  constantly  moved  around,  to  the  annoy- 
ance of  the  patient.  A  bed,  bureau,  wash- 
stand,  small  table  by  the  bedside,  and  two  or 
three  comfortable  chairs  are  really  all  that  is 
required ;  and  the  chairs  are  much  better  with- 
out rockers,  as  constant  motion  is  sometimes 
very  irritating  to  a  nervous  patient.  A  sofa  or 
lounging  chair  will  be  needed  during  convales- 
cence. Bright  pictures  on  the  walls,  dainty 
muslin  curtains,  that  can  easily  be  washed, 
some  interesting  books  and  photographs,  and 
a  few  fresh  flowers  will  assist  in  making  the 
room  bright  and  comfortable. 


ARRANGEMENT  OF  THE  BED 


Arrangement 
of  the  bed 


The  first  thing  to  be  considered  is  the  bed. 
A  firm  hair  mattress  should  always  be  used, 
with  a  thin  blanket  or  covering  of  some  kind 
under  the  lower  sheet. 

After  long  service  all  mattresses  are  inclined 
to  sink  in  the  middle  and  become  very  uncom- 
fortable to  lie  upon  for  any  length  of  time.  A 
blanket  folded  lengthwise  and  placed  under  the 
mattress  in  the  middle  of  the  bed,  or  two  flat 
pillows,  will  overcome  this  difficulty.  When 
there  is  much  fever,  a  hair  pillow,  though 
harder,  will  be  found  much  cooler  than  a 
feather  one. 

I  cannot  too  strongly  recommend  the  use  of 
a  number  of  small  pillows,  of  all  shapes  and 
sizes,  more  especially  during  long  cases  of  ill- 
ness, when  they  will  prove  of  the  greatest 
comfort,  for  you  can  tuck  them  in  odd  cor- 
ners, under  the  back  and  shoulders,  as  a  help 
to  keep  up  the  knees,  and  thus  take  all  strain 
from  the  back,  forming  comfortable  resting- 
places  for  injured  limbs,  and  supporting  the 
weight  of  the  clothes  from  sensitive  parts  of 
the  body.  I  heard  of  a  confirmed  invalid 
lately  who  found  such  comfort  out  of  an  assort- 


4  HOME  NUESING 

ment  of  pillows  that  she  made  use  of  no  less 
than  thirty  all  the  time,  and  by  changing  them 
round  in  different  positions  she  found  the 
greatest  rest  and  refreshment. 

Small  pillows  may  be  made  of  cotton  or 
wool,  covered  with  cheese-cloth  or  old  linen, 
and  will  answer  the  purpose  quite  as  well  as 
the  more  expensive  ones  of  feather  or  down. 

It  is  much  wiser  to  use  cotton  sheets  in  sick- 
ness instead  of  linen,  unless  perhaps  in  summer 
time,  as  there  is  a  certain  chilly  feeling  about 
linen  which  is  not  comfortable  to  a  delicate 
person. 

In  making  the  bed,  three  sheets  are  required, 
also  as  a  rule  a  piece  of  rubber  sheeting  about 
three-quarters  of  a  yard  wide  to  be  used  under 
the  draw  sheet.  In  cases  of  slight  illness, 
where  there  is  no  danger  of  the  patient  soiling 
the  mattress,  the  rubber  sheeting  may  be  dis- 
pensed with,  as  it  causes  unnecessary  perspira- 
tion, and  if  it  becomes  wrinkled  under  the 
patient  may  even  lead  to  bed-sores.  It  requires 
real  art  to  arrange  a  bed  for  a  sick  person,  so 
that  it  will  be  thoroughly  comfortable  and  free 
from  wrinkles. 

The  under  sheet  must  be  drawn  very 
smoothly  and  well  tucked  in.  If  your  patient 


ARRANGEMENT  OF  THE  BED  5 

is  heavy  or  inclined  to  restlessness,  you  will 
find  it  of  great  advantage  to  pin  the  under 
sheet  at  the  four  corners  with  safety  pins. 
Over  the  under  sheet  and  across  the  middle  of 
the  bed,  lay  the  rubber  sheet,  pin  it  at  the 
corners  and  cover  with  the  draw  sheet,  which 
is  a  small  sheet  folded  to  the  width  of  the 
rubber  and  tucked  firmly  over  it  on  both  sides 
of  the  bed.  The  advantage  of  the  draw  sheet 
is  that  it  may  be  changed  as  often  as  may  be 
required  without  disturbing  the  patient,  and 
it  serves  to  keep  the  under  sheet  clean  for  a 
much  longer  period. 

In  putting  on  the  upper  sheet  leave  a  good 
margin  turned  over  at  the  top  to  cover  the 
blanket.  Instead  of  a  heavy  white  spread, 
place  over  the  blanket  another  sheet  or  a 
dimity  counterpane.  The  heavy  bedspreads 
have  no  real  warmth  in  them,  and  only  give 
additional  weight  to  the  bedclothes,  which  is 
most  undesirable  while  your  patient  is  weak 
and  requires  all  his  strength.  I  will  explain 
later  how  a  bed  can  be  changed  without  dis- 
turbing the  patient. 

The  three  great  points  to  be  observed  about 
a  sick-bed  are  perfect  cleanliness,  no  crumbs, 
and  no  wrinkles.  Should  the  supply  of  linen 


6  HOME   NURSING 

be  limited,  as  it  often  is  during  a  long  illness, 
a  clean  pillow  case  can  be  made  to  do  duty  for 
a  double  period.  Change  it  at  night  and  hang 
it  out  to  air  until  the  morning,  when  it  will  be 
fresh  for  the  day.  The  upper  sheet,  which  is 
often  only  crushed  and  not  really  soiled,  can 
be  straightened,  folded,  and  used  for  a  draw 
sheet. 

Crumbs  should  be  brushed  off  after  every 
meal  with  a  little  whisk  broom,  and  the  draw 
sheet  pulled  tightly  and  smoothly  two  or  three 
times  during  the  day,  to  avoid  wrinkles. 

Light 

Sunlight  is  one  of  the  necessities  of  a  sick- 
room. Even  should  the  windows  have  to  be 
darkened  at  the  commencement  of  an  illness, 
as  soon  as  your  patient  is  convalescent  plenty 
of  sunshine  will  be  of  inestimable  value,  both 
mentally  and  physically.  It  is  a  great  purifier 
and  healer,  and  should  not  be  excluded  unless 
for  especial  reasons.  If  the  light  is  too  strong 
for  the  eyes,  you  may  tone  it  by  drawing  down 
the  shades  or  by  placing  a  screen  between  the 
windows  and  bed.  If  you  keep  the  room  dark, 
or  with  a  "  dim  religious  light,"  your  patient's 
eyes  will  be  weak  and  delicate  for  a  long  time. 


HEAT  7 

Never  allow  a  bed  to  face  a  window,  as  light 
falling  directly  on  the  eyes  is  very  distressing. 
At  night  darken  the  lamp  or  gas,  by  means  of 
a  small  shade  ;  a  newspaper  fastened  with  a 
bent  hairpin  on  the  side  of  the  globe  nearest 
the  patient  answers  the  purpose,  or  a  pretty 
flower  shade  can  quickly  and  easily  be  made 
with  bright  colored  tissue  paper  cut  in  the 
shape  of  large  rose  leaves  and  fastened  with 
mucilage  on  a  piece  of  stiff  net.  The  leaves 
must  be  very  full  and  graduate  toward  the 
centre,  and  this  inexpensive  little  shade  may 
be  fastened  by  wire  on  the  globe,  and  will  look 
bright  and  dainty  both  day  and  night. 

Heat 

In  very  cold  weather  it  is  sometimes  difficult 
to  keep  a  sick-room  at  an  even  temperature, 
and  when  there  is  no  open  fireplace,  a  small 
gas  stove  should  be  on  hand  in  case  of  emer- 
gency. 

A  thermometer  must  hang  near  the  middle 
of  the  room,  at  some  distance  from  the  window 
or  fireplace,  so  as  to  record  the  exact  temper- 
ature, which  should  be  carefully  regulated. 
In  ordinary  cases  a  temperature  of  70°  F.  is 
the  best,  but  where  there  is  much  fever,  as  in 


8  HOME  NURSING 

typhoid  or  scarlet  fever,  etc.,  the  room  should 
not  be  warmer  than  65°  F.  In  the  early  morn- 
ing hours,  between  three  and  five  o'clock,  the 
atmosphere  is  colder  than  during  any  other 
part  of  the  day,  and  as  the  vitality  of  the  body 
is  always  lower  at  that  time,  care  must  be  taken 
to  have  extra  blankets  on  hand  for  the  invalid, 
and  if  necessary  give  a  hot  drink  and  apply  a 
hot  water  bag  to  the  feet.  This  is  especially 
to  be  noted  with  elderly  people  and  in  very 
serious  cases  of  illness. 

Open  fireplaces  are  delightful  in  a  sick 
room,  for  besides  their  bright,  cheery  appear- 
ance, and  the  heat  they  give  forth,  they  are  a 
great  help  in  regard  to  ventilation.  Coal  may 
be  renewed  at  any  time  without  disturbing  your 
patient,  by  carrying  it  in,  wrapped  in  a  news- 
paper, and  placing  paper  and  coal  together  on 
the  fire.  A  poker  made  from  a  piece  of  wood 
will  cause  no  noise,  and  will  be  found  quite  as 
useful  as  one  of  iron  or  brass.  In  summer 
time,  when  there  is  no  need  of  fire,  a  lighted 
candle  placed  in  the  fireplace  will  have  the 
same  effect  as  a  fire  in  the  way  of  ventilation, 
by  causing  a  draught  up  the  chimney. 


VENTILATION  9 

Ventilation 

The  bed  should  stand  a  little  out  from  the 
wall  on  all  sides,  so  that  the  air  may  circulate 
around  it;  and  when  the  weather  becomes 
very  warm,  much  comfort  will  be  found  by 
placing  the  bed  in  the  middle  of  the  room,  with 
a  screen  to  protect  the  head  from  draughts. 

At  all  times  it  is  most  important  that  the 
sick-room  be  well  ventilated ;  indeed,  more 
fresh  air  is  needed  during  sickness  than  in 
health,  as  the  body  is  weak,  and  the  lungs  re- 
quire an  additional  supply  of  oxygen. 

Even  during  very  cold  weather  it  is  possible 
to  have  thorough  ventilation  in  the  room,  with- 
out exposing  your  patient  to  draughts.  There 
are  different  ways  of  providing  for  this,  accord- 
ing to  the  size  of  the  room  and  the  number  of 
windows  in  it.  Should  there  be  two  windows 
facing  each  other,  both  of  them  may  be  left 
open  two  or  three  inches  at  the  top,  thus  caus- 
ing a  continuous  current  of  air,  but  high 
enough  above  the  head  of  the  bed  to  prevent 
a  draught.  If  there  is  only  one  window  in 
the  room,  open  it  at  the  top  instead  of  the 
bottom,  so  that  the  air  should  not  blow  in 
directly  on  a  level  with  the  bed.  Hot  air 
always  rises,  and  cold  air  descends,  so  that  the 


10  HOME  NURSING 

impure  air  will  escape  through  the  top  of  the 
window,  and  the  fresh  air  gradually  find  its 
way  down  through  the  room.  Another  good 
method  of  airing  the  room  is  to  open  the  win- 
dow about  three  or  four  inches  from  the  bot- 
tom, and  place  a  piece  of  cardboard,  or  thin 
strip  of  wood  six  or  eight  inches  wide,  over, 
but  a  little  away  from,  the  opening.  Then 
the  air  will  not  blow  directly  into  the  room, 
but  is  permitted  to  enter  gradually  in  an  up- 
ward direction.  The  bed  should  always  be 
protected  from  draughts  by  a  screen,  and  when 
the  door  of  a  room  is  left  open  a  screen  must 
be  placed  between  the  bed  and  the  open  door. 
Some  people  prefer  the  method  of  ventilating 
through  an  adjoining  room,  either  by  first  fill- 
ing the  next  room  with  fresh  air  and  allowing 
it  to  warm  gradually  and  then  open  the  door 
into  the  sick  room,  or  by  leaving  the  window 
open  top  and  bottom  in  the  adjoining  room  all 
day,  and  allowing  the  fresh  air  to  enter  the 
sick  room  through  a  partly  open  door.  This 
is  the  wisest  course  to  follow  in  cases  of  bron- 
chitis or  pneumonia,  where  a  breath  of  fresh 
air  is  likely  to  increase  the  cough. 

Every   morning    and   evening    the   window 
should  be   opened  wide  for  a  few  moments, 


VENTILATION  11 

but  you  must  cover  the  patient  very  carefully 
with  extra  blankets,  placing  a  shawl  over  head 
and  mouth. 

Should  there  be  an  unpleasant  odor  in  the 
room  at  any  time,  take  a  towel  or  newspaper 
in  each  hand,  waving  them  gently  to  and  fro 
while  the  window  is  open.  This  is  a  good 
method  to  use  in  summer,  when  there  is  little 
wind,  as  it  helps  the  air  to  circulate  rapidly 
and  makes  the  room  cool  and  fresh. 

In  fever  cases  it  is  absolutely  important  to 
have  a  current  of  fresh  air  passing  through  the 
room  all  the  time  ;  when  the  temperature  is 
high,  it  is  almost  impossible  for  the  patient  to 
catch  cold,  and  plenty  of  fresh  air  will  hasten 
the  recovery  very  materially  by  lowering  the 
temperature. 

It  is  not  always  possible  for  the  invalid  to 
know  when  the  air  of  the  room  needs  chang- 
ing, as  one  becomes  accustomed  to  a  close 
atmosphere  after  breathing  it  for  any  length 
of  time.  But  if  you  enter  the  room  from  the 
open  air,  or  from  another  part  of  the  house,  you 
will  notice  at  once  the  difference  in  the  atmos- 
phere. Opening  the  window  for  a  moment 
before  meals  will  help  to  stimulate  the  appe- 
tite, as  it  is  impossible  to  feel  hungry  in  a 


12  HOME  NURSING 

close  hot  room.  I  was  called  to  a  case  in  the 
mountains  one  summer  ;  it  was  a  case  of  diph- 
theria in  the  family  of  one  of  the  mountain 
guides,  and  upon  arriving,  though  it  was  a 
very  hot  day  in  August,  I  found  all  the  win- 
dows firmly  closed,  not  only  in  the  room  where 
the  sick  girl  lay,  but  throughout  the  house. 

My  first  move  was  to  open  a  window  in  the 
sick-room,  taking  care  to  shield  my  patient 
from  any  draught.  The  family  were  horrified, 
and  begged  me  to  shut  it  at  once,  saying  that 
no  window  had  been  opened  in  the  house  since 
the  beginning  of  the  disease,  although  the 
brother  of  my  patient  and  her  little  niece  had 
died  of  the  disease  a  few  days  before  my 
arrival. 

However,  I  persuaded  them  to  trust  to  my 
knowledge  of  what  was  best;  and  ere  long  I 
had  a  window  open  in  every  room  of  the  house. 
I  am  sure  it  was  largely  in  consequence  of  the 
abundance  of  fresh  air  that  my  little  patient 
was  soon  on  her  feet  again  ;  and  that  the  three 
other  members  of  the  family,  who  developed 
the  disease  within  the  next  two  days,  had  much 
lighter  attacks  and  no  serious  complications. 

They  told  me  afterward  that  the  country 
doctor  in  charge  of  the  case  would  not  allow 


PUTTING  THE  SICK-ROOM  IN  ORDER  13 

the  windows  to  be  opened  for  fear  of  spread- 
ing the  disease  to  the  village  half  a  mile  away. 
He  has  yet  to  learn  that  fresh  air  is  one  of  the 
best  disinfectants  we  have. 

Putting  the  sick- 
room in  order 

An  hour  spent  each  morning  tidying  the 
sick-room  will  make  it  pleasant  and  attractive 
for  the  day. 

After  the  daily  bath  is  given,  hair  brushed, 
teeth  and  finger-nails  cleaned,  bed  changed, 
and  all  soiled  clothing  removed,  brush  off  the 
carpet  either  with  a  carpet  sweeper  or  a  broom 
having  a  damp  cloth  tied  over  it  to  prevent 
the  dust  rising.  Then  dust  round  softly,  with- 
out any  unnecessary  disturbance,  using  a  cloth 
slightly  damp. 

A  feather  duster  is  an  abomination  in  a  sick- 
room, sending  most  of  the  dust  into  the  pa- 
tient's throat.  Perfect  cleanliness  should  be 
the  rule.  To  prevent  all  bad  odors,  do  not 
allow  any  soiled  clothing  to  remain  in  the 
room  a  moment  longer  than  necessary,  and 
remove  all  evacuations  as  quickly  as  possible. 
Bed-pans  and  urinals  should  be  washed  with 
soap,  hot  water,  and  ammonia,  and  in  fever 


14  HOME  NURSING 

cases  rinsed  off  with  a  disinfectant  solution ; 
if  possible,  never  keep  these  vessels  in  the  sick- 
room, but  in  a  dressing-room  or  bath-room 
near  at  hand. 

Empty  dishes  and  glasses  lying  about  have 
a  very  untidy  appearance  and  only  serve  to 
attract  flies.  All  medicine  bottles  or  surgical 
appliances  should  be  kept  out  of  sight  of  the 
patient.  Blood  stains  may  be  removed  from 
the  bedclothes  or  carpet  by  Javelle  water,  or 
a  little  paste  made  with  starch  and  water,  ap- 
plied thickly  on  the  stains,  and,  when  dry, 
washed  off  with  soap  and  water. 

Nervous  patients  have  frequently  told  me 
that  it  makes  the  greatest  difference  to  them 
how  the  sick-room  looks,  as  they  cannot  rest 
quietly  if  anything  in  the  room  is  in  the 
slightest  degree  out  of  order. 

Flowers 

Growing  plants  and  flowers  are  charming  in 
a  sick-room,  and  their  bright  loveliness  has  a 
good  moral  and  cheering  effect.  Plants  should 
be  watered  daily,  and  the  water  in  which  cut 
flowers  are  placed  should  be  changed  each 
morning.  At  night  it  is  better  to  remove  the 
flowers  out  of  the  room,  for  besides  keeping 


SCREENS  —  REFRIGERATORS  15 

them  fresher,  it  leaves  the   air   of  the   room 
purer  during  the  night. 

To  keep  flowers  fresh  for  a  long  time,  take 
them  out  of  their  vases  at  night,  cut  off  a  tiny 
piece  of  the  stem  in  a  slanting  direction,  and 
put  them  in  a  large  bowl  with  plenty  of  water, 
or  lay  them  in  a  box  sprinkled  with  water, 
cover  tightly,  and  put  it  outside  the  window. 
Flowers  are  most  refreshing  to  the  sick,  and,  as 
a  rule,  are  appreciated  as  a  gift  more  than  any 
amount  of  broth  or  jelly. 

Screens 

A  screen  of  some  kind  is  invaluable  in  a  sick- 
room, especially  one  of  the  lighter  kind  that 
can  easily  be  moved  about  the  room.  Should 
there  be  no  suitable  screen  in  the  house,  it  is 
very  easy  to  manufacture  one  from  a  clothes- 
horse,  with  a  few  yards  of  art  muslin  or  cheese- 
cloth sewed  neatly  over  it. 

Refrigerators 

Small  bedroom  refrigerators,  or  ice-boxes, 
which  can  be  purchased  for  a  small  sum,  are  of 
great  service  if  the  illness  should  be  a  long 
one.  They  have  one  compartment  for  ice, 
another  for  fruit  and  jellies,  and  a  third  for 


16  HOME  NURSING 

milk  and  broths.  They  save  many  steps  up 
and  down  stairs  ;  and  after  being  replenished 
every  morning,  the  supply  of  dainties  is  on 
hand  all  the  time  fresh  and  cold. 

In  cases  of  infectious  diseases  these  little  re- 
frigerators are  of  great  value,  as  all  eatables 
for  the  sick  one  should  be  kept  apart  from  the 
general  supply. 

When  the  illness  is  of  short  duration,  or  if 
these  little  ice-boxes  are  too  much  of  a  luxury, 
the  best  way  to  preserve  the  ice  is  to  wrap  it 
in  a  piece  of  flannel,  and  place  it  on  a  bowl  or 
cup  turned  upside  down  inside  a  large  hand- 
basin.  You  may  then  place  the  broths,  milk, 
or  jellies  in  the  basin  resting  against  the  ice, 
and  cover  all  with  a  towel  or  table-napkin  and 
stand  the  basin  near  a  window.  For  cracking 
the  ice,  miniature  ice-picks  may  be  purchased, 
or  an  ordinary  pin  serves  to  break  it  very 
nicely.  When  necessary  to  crack  a  large 
quantity  of  ice  for  an  ice-bag  or  ice-cap,  put 
the  ice  in  a  towel  and  break  it  with  a  hammer 
or  iron.  If  it  is  absolutely  necessary  to  keep 
water  or  milk  in  the  room,  always  have  it  care- 
fully covered.  Sometimes  broth  or  milk  is 
needed  during  the  night,  and  where  there  is  no 
ice  on  hand,  you  will  be  able  to  keep  it  cool  by 


AEKANGEMENT  OF  PILLOWS  17 

wrapping  the  pitcher  or  bottle  in  a  damp  towel 
and  standing  it  outside  the  window. 

Arrangement 
of  pillows 

The  pillows  should  be  turned  frequently,  as 
they  soon  get  hot  and  uncomfortable,  and  they 
also  need  a  good  shaking  occasionally,  which, 
however,  must  not  be  done  on  the  bed,  as  it 
jars  the  patient. 

In  order  to  raise  a  sick  person  while  changing 
the  pillows  or  to  draw  him  up  in  the  bed,  let 
him  clasp  his  arms  firmly  around  your  neck, 
then  place  one  hand  well  under  his  back,  and 
lift  gently  and  slowly,  while  with  the  other 
hand  you  slip  out  the  soiled  pillow  and  put  in 
the  clean  one.  When  the  patient  is  too  sick 
to  help  himself,  get  some  one  to  assist  you,  and 
with  one  person  on  each  side  of  the  bed,  clasp- 
ing each  other's  wrists  firmly  under  the  shoul- 
ders and  back  of  the  patient,  you  can  raise  and 
draw  him  up  in  bed  without  any  strain  or  fatigue. 

Bed-sack 

A  loose  flannel  jacket  or  nightingale  is  very 
comfortable  in  bed,  worn  over  the  nightgown, 
as  it  allows  the  arms  to  be  kept  from  under 


18  HOME  NUESING 

the  bedclothes  without  taking  cold.  This 
should  always  be  removed  at  night  before 
going  to  sleep. 

During  the  hot  weather,  if  the  flies  prove 
troublesome,  you  will  give  great  relief  to  the 
patient  by  making  a  canopy  over  the  bed  with 
a  large  piece  of  mosquito  netting  fastened  to  a 
hook  in  the  ceiling,  over  the  centre  of  the  bed, 
and  long  enough  to  reach  to  the  floor  on  all 
sides. 


Change  of 
position 


This  can  be  accomplished  when  the  bed  is 
a  double  one  by  keeping  one  side  for  the  day 
and  the  other  for  night.  You  can  easily  move 
your  patient  by  drawing  him  over  on  a  sheet, 
if  he  is  too  feeble  to  roll  over  alone,  and  it  is 
almost  as  restful  as  moving  on  to  a  fresh  bed. 
Should  there  be  two  small  beds  in  the  room, 
the  same  change  can  be  made  by  putting  a 
large  sheet  across  the  two  beds  and  allowing 
the  patient  to  roll  over,  or  draw  him  with  the 
sheet.  When  the  illness  extends  over  a  few 
weeks,  the  change  from  one  bed  to  another  will 
be  of  the  greatest  rest  and  comfort  to  the 
dufferer. 


HOW  TO   CHANGE  THE  SHEETS  19 

Nightgowns 

I  always  find  it  most  refreshing  to  keep  on 
hand  two  nightgowns  and  undervests  (if  they 
are  worn),  one  for  day  duty  and  the  other  for 
night,  changing  the  last  thing  at  night  and 
after  the  morning  bath.  It  may  be  possible  to 
have  a  clean  nightgown  on  every  day,  but  if 
not  this  change  will  be  very  delightful,  and  it 
will  be  found  very  restful  as  well  as  refreshing 
to  change  the  clothes  that  have  been  worn  for 
twelve  hours.  Another  consideration  is  that 
the  gowns  are  kept  cleaner,  and  thus  the  wash- 
ing, always  a  serious  item  in  sickness,  is  much 
lightened. 

How  to  change 
the  sheets 

With  regard  to  changing  the  sheets  on  a  bed 
when  the  patient  is  in  it,  you  may  easily  man- 
age after  a  little  practise.  Have  the  clean 
sheets  ready,  well  aired  and  warmed,  and  shut 
the  door  and  windows,  so  that  the  room  may 
be  comfortable.  The  under  sheet  is  changed 
first.  Turn  the  patient  over  on  one  side,  away 
from  you,  fold  the  soiled  sheet  tightly,  in  flat 
folds,  close  up  to  the  patient.  Lay  the  clean 
sheet  on  the  side  of  the  bed  near  you,  half  of  it 


20  HOME  NURSING 

folded  up  against  the  roll  of  the  soiled  sheet, 
so  that  they  can  both  be  slipped  under  the 
body  at  the  same  time.  Tuck  in  the  clean 
sheet  on  that  side  of  the  bed,  then  cross  to  the 
other  side,  turn  your  patient  back  on  the  oppo- 
site side,  gently  pull  out  the  soiled  sheet  from 
underneath,  and  afterward  draw  the  folds  of 
the  clean  one.  Pull  straight,  firmly,  and  tuck 
in  neatly.  It  is  quite  easy  in  this  way  to 
change  the  draw  sheet,  rubber  sheeting,  and 
under  sheet  all  at  the  same  time.  To  change 
the  upper  sheet  without  exposing  your  patient, 
loosen  all  the  clothes  at  the  foot  of  the  bed, 
and  spread  the  clean  sheet  and  a  blanket  on 
top  of  the  other  bedclothes.  Then  with  one 
hand  hold  the  clean  sheet  and  blanket  up  to 
the  neck  of  your  patient,  and  with  the  other 
slip  down  the  soiled  clothes  underneath  right 
over  the  foot  of  the  bed ;  tuck  in  the  fresh 
bedclothes  and  put  on  the  counterpane.  All 
this  may  be  accomplished  in  almost  as  short 
a  time  as  it  takes  to  tell  it,  and  without  any 
especial  fatigue  to  the  invalid. 

Sitting  on  the  side  of  the  bed  or  leaning 
heavily  against  it  ought  not  to  be  allowed,  as 
it  is  very  trying  to  a  nervous  patient. 


SUPPORT  FOR  BEDCLOTHES  21 


Support  for 
the  bedclothes 


If  any  part  of  the  body  is  injured  and  unable 
to  bear  the  weight  of  the  bedclothes,  you  can 
manufacture  a  support  to  take  the  place  of  the 
iron  cradles  used  in  hospitals.  Two  or  three 
barrel  hoops  will  answer  the  purpose,  or  a 
round  band-box  large  enough  to  slip  the  in- 
jured limb  through.  Sometimes  pillows  laid 
on  each  side  of  the  bed  will  answer  as  well  by 
keeping  the  clothes  a  couple  of  inches  from  the 
sensitive  part  of  the  body. 


Bed-rests 

Bed-rests,  which  are  of  such  great  service 
when  the  patient  first  sits  up  in  bed,  are  not  as 
a  rule  on  hand  in  private  houses.  But  one 
may  easily  be  contrived  from  a  chair  with  the 
legs  turned  upward  on  the  bed,  when  the  long 
sloping  back  will  form  a  capital  support  for  pil- 
lows piled  in  one  behind  another  to  the  top. 
Then  if  you  put  a  small  pillow  under  the  knees, 
to  prevent  the  body  from  slipping  down  in  the 
bed,  your  patient  will  be  made  very  comfort- 
able, and  will  probably  want  to  remain  sitting 
up  in  bed  longer  than  the  prescribed  time. 


22  HOME  NURSING 

Bed-sores 

It  is  very  necessary  to  be  on  your  guard 
against  bed-sores,  even  during  a  short  illness, 
as  some  people  have  very  sensitive  skins,  and  a 
continual  pressure,  even  for  a  few  days,  may 
cause  trouble. 

The  back,  elbows,  knees,  and  heels,  but  more 
especially  the  back,  are  the  places  where  the 
bed-sores  will  be  found,  and  when  the  vitality 
is  weakened  by  fever  or  from  other  causes,  it 
takes  very  little  in  the  way  of  pressure,  mois- 
ture, or  continued  dampness,  and  even  wrinkles 
in  the  sheets,  or  crumbs,  to  produce  these 
dreadful  sores. 

To  prevent  as  far  as  possible  any  appearance 
of  them,  bathe  the  parts  with  warm  water  and 
soap  every  day,  rub  briskly  with  alcohol  to 
harden  the  skin,  and  dust  on  some  simple 
powder,  such  as  talcum  or  bismuth  powder,  to 
remove  all  moisture.  Do  not  allow  crumbs  or 
wrinkles  in  the  nightgown  or  under  the  sheet, 
and  persuade  the  patient  to  turn  in  different 
positions  every  few  hours  so  that  there  will  not 
be  any  long-continued  pressure  on  one  spot. 
With  unconscious  patients  the  greatest  watch- 
fulness is  required,  and  when  there  are  involun- 
tary evacuations,  the  clothing  must  be  changed 


VISITORS  23 

immediately,  and  the  body  thoroughly  washed 
and  powdered.  It  is  far  easier  to  prevent  bed- 
sores than  to  cure  them.  In  paralytic  cases,  and 
with  elderly  people,  they  are  most  difficult  and 
sometimes  impossible  to  heal.  The  first  symp- 
toms of  a  bed-sore  are  a  redness  of  the  skin 
with  a  pricking,  burning  sensation. 

It  should  be  watched  very  closely,  and  all 
pressure  taken  off  the  part  by  the  judicious  use 
of  air  cushions,  soft  pads,  which  may  be  made 
from  cheese-cloth  and  cotton  and  can  be  boiled 
every  week,  hair  pillows,  or  rubber  rings. 
When  the  skin  becomes  broken,  stop  using 
alcohol  and  apply  a  little  dressing  of  oxide  of 
zinc  ointment  or  balsam  of  Peru  on  a  piece  of 
gauze  covered  with  a  pad.  If  it  does  not  heal 
immediately,  it  is  better  for  you  to  consult  the 
family  doctor  and  let  him  prescribe  further 
treatment. 

Visitors 

One  of  the  unsolved  problems  of  the  sick 
room  is  what  to  do  about  visitors.  If  people 
would  only  use  a  little  common  sense  when 
visiting  their  sick  friends,  their  visits  would 
do  good  to  the  patient  instead  of  sometimes 
causing  trouble. 


24  HOME  NURSING 

Do  not  allow  a  visitor  to  enter  the  sick-room 
straight  from  the  open  air  on  a  cold  or  wet  day. 
Ask  him  to  wait  in  an  adjoining  room  for  a 
few  moments  until  his  clothes  lose  their  damp- 
ness and  become  warm.  Visitors  should  be 
warned  to  put  aside  all  depressing  news,  and 
be  as  bright  and  cheery  as  possible,  bringing 
in  with  them  a  little  sunshine  and  news  of 
the  outside  world,  instead  of  retailing  to  the 
patient  the  sorrows,  sickness,  or  death  of 
mutual  friends. 

It  is  necessary  to  discriminate  carefully  as 
to  whom  you  admit  to  visit  the  invalid,  as 
sometimes  a  visit  from  a  relative  who  is  fussy 
and  irritating  will  do  your  patient  a  great  deal 
of  harm,  while  a  loving,  sympathetic  friend 
may  have  it  in  her  power  to  refresh  and 
strengthen  the  sufferer. 

After  a  serious  illness  when  the  doctor  allows 
visitors  to  be  seen,  one  friend  during  the  day 
is  sufficient  for  the  first  few  days,  and  his  visit 
should  be  limited  to  a  very  few  minutes.  At 
the  end  of  the  prescribed  time,  if  the  visitor  has 
not  the  tact  to  leave,  you  should  not  hesi- 
tate to  request  him  to  do  so.  Unless  one  has 
been  through  a  serious  illness,  it  is  impossible 
to  realize  how  exciting  it  is  to  see  even  a  very 


CONVALESCENCE  25 

intimate  friend,  after  being  shut  out  from  the 
busy  everyday  world  for  days  or  weeks.  A 
nervous  patient  should  never  be  allowed  to  see 
two  visitors  at  the  same  time.  It  fills  one  with 
the  deepest  sympathy  for  the  invalid  to  see 
two  friends,  seated  on  opposite  sides  of  the  bed, 
talking  across  at  each  other,  while  the  poor 
sufferer  lies  in  the  middle,  trying  not  to  look 
distressed  and  tired  with  the  effort  he  has  to 
make  to  watch  and  listen  to  them  both  at  the 
same  time. 

Have  a  chair  placed  facing  the  invalid,  and 
near  enough  for  him  to  hear  what  is  said  with- 
out an  effort,  and  the  first  indication  of  weari- 
ness should  be  the  signal  for  the  immediate 
departure  of  the  visitor. 

Household  worries  of  all  kinds  ought  to  be 
kept  outside  the  door  as  far  as  possible,  and 
only  the  bright  side  of  life  allowed  to  cross 
the  threshold.  It  is  only  human  nature  that 
when  we  are  sick  little  things  affect  and  worry 
us,  which  we  would  scorn  to  notice  in  perfect 
health. 

Convalescence 

The  convalescent  period  is  very  trying  both 
to  nurse  and  patient.  As  soon  as  the  invalid 


26  HOME  NURSING 

begins  to  sit  up  every  day,  he  will  require 
a  great  deal  of  encouragement  to  brace  him 
up,  as  it  is  then  he  will  realize  his  great 
weakness. 

It  is  not  wise  to  allow  the  patient  to  sit  up 
long  at  a  time ;  half  an  hour  the  first  day  will 
be  found  quite  sufficient,  and  after  the  first  day 
sitting  up  for  a  short  time,  twice  in  the  day 
instead  of  a  longer  period  at  one  time,  will 
be  found  far  less  tiring.  Turn  the  mattress 
and  allow  the  bed  to  air  while  your  patient 
is  out  of  it.  The  pleasure  of  being  up  at 
first  is  so  great,  that  people  are  apt  to  go 
beyond  their  strength,  not  realizing  that  a 
reaction  will  come  afterward,  so  you  must 
insist  upon  the  invalid  returning  to  bed  before 
the  slightest  weariness  is  felt.  Sitting  up  in 
an  easy  chair  is  better  than  reclining  on  a  sofa, 
as  it  is  a  complete  change  from  the  bed,  and 
helps  to  restore  the  strength  more  rapidly. 

After  the  first  day  or  two,  unless  the  doctor 
gives  special  directions  about  it,  a  few  steps 
should  be  taken,  increasing  them  slowly  each 
day  until  the  limbs  have  regained  their 
strength.  Some  invalids  lose  all  desire  to 
walk,  and  have  to  be  coaxed  and  encouraged 
to  commence.  In  one  case  I  found  it  neces- 


CONVALESCENCE  27 

sary  to  put  the  chair  a  little  farther  from  the 
bed  each  day,  and  insist  on  my  patient  walk- 
ing to  it,  so  that  by  slow  degrees  she  was 
persuaded  to  walk  across  the  room. 

When  the  patient  is  well  enough  to  sit  up, 
though  unable  to  go  out  of  doors,  you  may 
give  him  a  great  deal  of  pleasure  and  fresh 
air,  by  wrapping  him  in  blankets  and  shawls, 
taking  care  to  cover  the  head  completely,  and 
then  open  wide  the  window  and  close  the  door 
to  prevent  draughts.  Let  him  sit  near  the  win- 
dow or  walk  round  the  room  for  half  an  hour. 
This  will  be  found  almost  as  refreshing  as 
a  drive  through  the  streets.  After  shutting 
the  window,  do  not  remove  the  extra  wraps 
for  a  few  minutes  until  the  room  becomes 
warm. 

Reading  aloud  is  a  delightful  way  to  pass 
away  the  time,  but  a  little  tact  must  be  exer- 
cised in  selecting  the  books  to  be  read,  and  do 
not  tire  your  patient  by  reading  too  long  without 
intermission.  The  strain  of  listening  for  more 
than  an  hour  at  a  time  is  very  tiring  to  the 
nerves.  Simple  little  games  that  are  not  too 
exciting  make  a  pleasant  variety  in  the  long 
day.  Do  not  allow  the  invalid  to  read  or 
write  for  more  than  half  an  hour  without  rest- 


28  HOME  NURSING 

ing,  if  the  eyes  are  weak,  as  using  them  while 
in  a  recumbent  position  is  likely  to  strain 
them.  As  soon  as  possible  get  your  patient 
out  into  the  open  air.  This  can  be  done  ever 
before  he  is  able  to  walk  downstairs,  by  hav- 
ing him  carried  to  the  carriage  seated  in  an 
ordinary  chair.  There  is  great  healing  prop- 
erty in  the  open  air  —  healing  to  both  mind 
and  body,  and  a  drive  of  even  fifteen  minutes 
or  half  an  hour  in  God's  glorious  sunshine  will 
often  do  more  than  any  medicine. 

During  convalescence  it  is  especially  neces- 
sary to  tempt  the  appetite  with  dainty  dishes, 
nicely  served.  Some  patients  try  to  get  well 
too  quickly,  and  have  to  be  held  back,  as  they 
run  the  risk  of  having  a  relapse  by  drawing 
too  much  on  their  newly  acquired  strength. 
Tact  is  of  the  utmost  importance  in  nursing 
the  sick.  Sometimes  it  is  necessary  to  insist 
upon  their  doing  things  to  which  they  strongly 
object,  and  it  is  only  by  gentle  persuasion  that 
they  will  yield.  Ordering  or  insisting  upon 
the  fulfilment  of  your  object  will  be  of  no 
avail  and  only  excite  and  annoy  them.  If,  for 
instance,  you  cannot  persuade  them  to  take 
a  disagreeable  medicine,  do  not  urge  the  point, 
but  lay  it  aside  for  a  time.  Upon  returning 


CONVALESCENCE  29 

to  it  a  little  later,  you  will  generally  find  that 
your  patient  has  changed  his  mind.  Infinite 
patience  is  needed  to  put  up  with  all  their  little 
whims  and  fancies.  It  is  not  always  wise  to 
keep  asking  an  invalid  what  he  would  like,  or 
what  he  wishes  you  to  do,  whether  it  be  a 
drink,  a  pillow  changed,  a  blind  closed,  a  little 
reading,  or  any  other  attention.  Do  what  you 
think  best  at  the  time,  unless  it  is  absolutely 
necessary  to  consult  him,  and  in  nine  cases  out 
of  ten,  what  you  do  will  be  appreciated  much 
more  than  if  he  had  to  decide  the  question. 

Anything  in  the  shape  of  a  little  surprise, 
either  something  dainty  to  eat  or  drink,  a  few 
flowers,  a  new  book  or  magazine,  a  pretty 
picture,  or  simply  some  cheery  bright  words 
of  sympathy  and  comfort,  will  go  a  long  way 
in  brightening  the  weary  days,  and  will  bring 
a  gleam  of  sunshine  into  the  shut-in  life. 


CHAPTER  II 

Temperature 

The  temperature  of  the  body  is  a  very  im- 
portant factor  in  the  treatment  of  disease. 
When  any  part  of  the  system  is  out  of  order, 
it  is  at  once  shown  by  a  rise  or  fall  of  tempera- 
ture; and  if  there  should  be  a  difference  of 
more  than  a  degree  above  or  below  the  normal 
mark,  without  any  apparent  cause,  such  as  sud- 
den alarm  or  intense  nervous  excitement,  you 
may  take  it  as  a  sign  that  trouble  is  brewing 
somewhere. 

It  is  not  difficult  to  take  a  person's  tempera- 
ture, and  at  least  one  member  of  every  family 
should  be  able  to  use  a  little  clinical  ther- 
mometer. 

The  normal  temperature  of  the  body  is  98.4° 
F.,  the  normal  pulse  72  beats  to  the  minute, 
and  the  respiration  18  breaths  to  the  minute. 
These  are  considered  the  average  marks,  but  it 
must  be  remembered  that  there  is  apt  to  be  a 
slight  variation  above  or  below  the  average,  ac- 
cording to  the  temperament  of  the  individual. 
30 


HOW  TO  USE  A  THERMOMETER  31 

For  instance,  an  easy-going,  placid  person  will 
have  a  slower  pulse,  and  frequently  a  lower 
normal  temperature,  than  one  of  a  nervous  ex- 
citable disposition.  A  rise  in  temperature,  or 
an  increase  in  the  pulse  and  respiration,  is  not 
as  important  in  a  child  as  in  an  adult,  and  as  a 
rule  they  have  a  higher  normal  mark.  It  must 
also  be  remembered  that  women  are  apt  to  have 
a  slightly  higher  normal  temperature  than 
men. 


How  to  use  a 
thermometer 


Before  using  a  clinical  thermometer  shake  it 
carefully  (holding  the  bulb  end  downwards), 
until  the  mercury  falls  below  the  mark  97°, 
then  insert  the  bulb  end  in  your  patient's 
mouth,  well  under  the  tongue,  make  him  close 
the  lips  firmly  so  that  no  air  will  enter,  and 
leave  it  there  for  a  full  three  minutes.  Unless 
the  lips  are  kept  tightly  closed  all  the  time  you 
will  not  get  the  true  temperature  of  the  body. 
At  the  end  of  three  minutes  remove  the  ther- 
mometer and  note  carefully  the  exact  position 
of  the  mercury,  that  is  to  say,  at  what  number 
on  the  thermometer  the  mercury  stands.  Be- 
fore using  the  thermometer  it  is  always  neces- 


32  HOME   NURSING 

sary  to  wash  the  bulb  in  cold  water,  and  after 
you  have  finished  dip  it  in  a  little  alcohol,  or 
some  disinfectant  solution,  to  guard  against 
any  chance  of  infection. 

In  fever  cases  the  thermometer,  which  is 
frequently  used  during  the  twenty-four  hours, 
should  be  kept  standing  all  the  time  in  a  glass 
containing  T^Vg-  corrosive  sublimate,  or  in  alco- 
hol. A  piece  of  cotton  wool  in  the  bottom  of 
the  glass  will  prevent  the  thermometer  break- 
ing, and  it  should  be  rinsed  off  in  plain  water 
before  inserting  in  the  mouth.  Perhaps  you 
are  not  aware  of  the  fact  that  the  temperature 
of  our  bodies  varies  at  different  hours  of  the 
day,  being  always  higher  in  the  afternoon  than 
it  is  in  the  morning,  generally  reaching  the 
highest  point  between  4  and  6  P.M.,  and  the 
lowest  between  2  and  4  A.M. 

It  is  necessary,  therefore,  to  take  your 
patient's  temperature  about  the  same  hour 
every  morning  and  evening,  so  that  you  will 
be  able  to  note  exactly  any  changes  that  may 
take  place  from  day  to  day.  Stimulating  meats 
and  drinks  tend  to  elevate  the  temperature  of 
the  body,  and  therefore  half  an  hour  or  an 
hour  should  elapse  after  meals  before  using  the 
thermometer.  Do  not  allow  hot  or  cold  drinks 


TEMPERATURE  BY  RECTUM  33 

or  ice  to  be  taken  for  at  least  fifteen  or  twenty 
minutes  before  using  the  thermometer  by 
mouth,  as  it  will  prevent  your  getting  the 
exact  temperature. 

Temperature 
by  rectum 

In  the  case  of  a  child  under  four  or  five 
years  of  age  it  is  almost  impossible  to  take  the 
temperature  by  mouth  as  it  is  difficult  to  pre- 
vent the  child  biting  the  thermometer,  and  im- 
possible to  make  him  keep  his  mouth  closed 
firmly  for  even  three  minutes.  The  only  safe 
way  is  to  take  it  by  the  rectum.  This  is  also 
necessary  in  the  case  of  a  delirious  or  uncon- 
scious patient,  and  in  typhoid  fever,  where  the 
temperature  has  to  be  closely  watched,  as  the 
rectal  temperature  is  considered  more  accurate. 
To  take  a  rectal  temperature,  after  shaking 
down  the  mercury,  cover  the  bulb  with  oil  or 
vaseline,  and  with  the  patient  lying  on  the  left 
s;de,  insert  the  thermometer  slowly  and  gently, 
about  an  inch  and  a  half  into  the  rectum,  hold- 
ing it  there  three  minutes.  Try  and  keep  the 
child  from  crying,  if  possible,  by  distracting 
his  attention,  as  crying  would  elevate  the 
temperature.  It  is  important  to  remember 


34  HOME  NURSING 

that  a  rectal  temperature  always  registers 
about  half  a  degree  higher  than  when  taken 
by  mouth. 


Pulse 


While  the  thermometer  is  being  used  you 
may  at  the  same  time  take  the  pulse  and  respi- 
ration. The  pulse  is  counted  by  placing  the 
first  and  second  finger  of  one  hand  lightly  on 
the  inside  of  your  patient's  wrist.  After  press- 
ing gently  but  firmly  you  will  feel  in  a  few 
seconds  the  steady  beat  of  the  pulse.  Then 
time  the  beat  by  a  watch,  counting  either  by 
the  half  minute,  and  doubling  the  result,  or  else 
counting  the  full  minute.  I  find  it  is  always 
best,  when  taking  the  pulse,  to  go  over  it  twice 
for  fear  of  making  a  mistake.  The  pulse  can 
be  counted  on  other  parts  of  the  body  besides 
the  wrist,  but  that  is  the  easiest  and  most  con- 
venient place  to  get  it  except  in  especial  cases. 
Sometimes  when  the  patient  is  sleeping  you 
will  be  able  to  count  the  pulse  in  the  temple 
better  than  at  the  wrist  without  disturbing 
him.  It  is  not  necessary  in  this  little  book  for 
home  nurses  to  go  into  details  about  the  dif- 
ferent kinds  of  pulse  beats  and  what  they  in- 
dicate ;  that  can  only  be  acquired  by  a  great 


RESPIRATION  35 

deal  of  practise  and  study,  and  does  not  come 
within  the  sphere  of  home  nursing. 

A  very  slight  cause  will  often  be  the  means 
of  increasing  the  pulse  beat  perceptibly,  and 
in  nervous  or  excitable  people  the  pulse 
sometimes  varies  according  to  their  feelings. 
I  have  had  a  nervous  patient  whose  pulse 
would  jump  up  to  120  when  a  knock  sounded 
at  the  door  or  the  doctor  entered  unexpectedly. 
When  the  temperature  and  pulse  rise  at  the 
same  time,  and  do  not  show  any  signs  of  going 
down  again  within  a  couple  of  hours,  it  is 
almost  certain  that  there  is  trouble  somewhere, 
and  you  will  do  well  to  consult  the  family 
doctor. 

Respiration 

If  possible,  count  the  respiration  without  the 
knowledge  of  your  patient,  because  if  he  is 
conscious  that  you  are  watching  his  respiration, 
it  will  be  impossible  for  him  to  breathe  natu- 
rally. You  can  easily  see  the  rise  and  fall  of 
the  chest  with  every  breath,  and  if  not  distinct 
enough  during  sleep  you  can  feel  it  by  placing 
your  hand  lightly  on  the  chest.  Respiration 
below  twelve  or  above  thirty  should  always  be 
watched  and  reported.  Temperature,  pulse, 


36  HOME  NURSING 

and  respiration  will  be  found  more  accurate  if 
you  take  them  when  your  patient  is  lying  down 
in  a  restful  position  instead  of  sitting  or  stand- 
ing. Lying  flat  on  the  back  is  a  great  rest  and 
refreshment  to  the  system,  and  generally  re- 
laxes and  soothes  the  nerves.  A  well-known 
physician  writes  that  a  woman  should  never 
stand  when  she  can  sit,  and  never  sit  when  she 
can  lie  down.  During  sleep  the  pulse  is  a 
little  slower  than  when  awake,  but  with  de- 
lirious people  and  children  it  is  necessary  to 
count  the  pulse  and  respiration  while  they 
sleep,  as  it  is  almost  impossible  to  take  them 
accurately  when  they  are  awake. 

Medicines 

There  is  much  to  be  learned  about  the  giv- 
ing of  medicines,  but  I  will  only  mention  a  few 
simple  rules  that  can  easily  be  followed,  and 
are  necessary  to  all  who  try  their  hand  at 
nursing. 

All  medicine  bottles  and  boxes  should  be 
most  distinctly  labelled  and  kept  carefully 
locked  away  out  of  the  reach  of  children.  I 
have  heard  a  pathetic  story  of  a  child  who  one 
day  told  his  mother  gleefully  that  he  had  given 
baby  a  pretty  white  candy  he  had  found  in  a 


MEDICINES  37 

little  box,  and  that  baby  had  gone  to  sleep  im- 
mediately !  On  investigation  the  poor  mother 
found  that  the  child  had  given  baby  a  morphine 
pill,  and  it  was  impossible  to  save  the  little 
one's  life. 

Never  give  a  medicine  of  any  kind,  no  matter 
how  well  you  know  the  bottle,  without  first 
taking  it  to  the  light  and  reading  the  name 
very  carefully.  Some  authorities  go  so  far  as 
to  say  that  the  label  ought  always  to  be  read 
twice  before  giving  the  medicine,  first  before 
pouring  it  out,  and  then  again  after  measuring 
it.  So  many  dreadful  accidents  have  occurred 
from  unintentional  carelessness  regarding  this 
important  rule,  that  I  cannot  enforce  it  too 
strongly.  Another  error  that  must  be  carefully 
guarded  against  is  the  practise  of  mixing  solu- 
tions or  lotions  in  various  bottles  and  letting 
them  stand  about  without  any  label  to  show 
what  the  mixture  is. 

I  had  an  experience  in  this  respect  with  one 
of  my  patients  that  might  have  ended  most 
disastrously.  One  morning  when  cleaning  her 
teeth  she  asked  for  the  listerine  bottle,  and  I 
handed  her  a  bottle  which  was  standing  on  her 
washstand  with  the  printed  label  on  it,  and  ap- 
parently half  full  of  listerine.  She  poured  some 


38  HOME  NURSING 

of  it  into  a  glass  of  water  and  took  a  mouthful 
to  rinse  her  mouth.  Fortunately  she  did  not 
swallow  it,  but,  noticing  a  peculiar  taste,  spat 
it  out  instantly  and  asked  me  where  I  had 
found  the  bottle.  I  told  her  it  was  on  her 
washstand,  and  showed  her  the  bottle  distinctly 
labelled  listerine  and  half  full  of  a  yellowish 
fluid  of  exactly  the  same  color.  She  then  ad- 
mitted with  dismay  that  she  had  made  a  strong 
solution  of  a  poisonous  acid  that  she  was  using 
for  some  purpose,  and  had  put  it  in  the  listerine 
bottle  without  removing  the  label  or  marking 
it  properly.  Nearly  all  medicines  need  to  be 
well  shaken  before  being  poured  out,  so  as  to 
thoroughly  mix  the  ingredients,  and  if  you 
pour  the  medicine  from  the  side  of  the  bottle 
away  from  the  label,  you  will  keep  the  name 
clean  and  prevent  its  being  blotted  out  by  drops 
falling  from  the  mouth  of  the  bottle. 

Always  replace  the  cork  immediately  after 
using.  All  tinctures  should  be  kept  in  a  dark 
place.  Some  drugs  change  character  when 
kept  many  months,  so  the  family  medicine 
chest  should  be  thoroughly  gone  over  every 
six  months  at  least,  and  the  remedies  no  longer 
needed  destroyed.  Pills  that  have  been  kept 
any  length  of  time  get  so  hard  that  they  will 


MEDICINES  39 

not  dissolve  in  the  stomach,  and  pass  out  of 
the  system  without  doing  any  good.  In  giving 
sleeping  medicines  wait  until  all  is  quiet  for 
the  night,  and  your  patient  comfortably  ar- 
ranged in  bed.  A  hot  drink  given  with  a 
sleeping  powder  will  hasten  its  effect.  Medi- 
cine should  always  be  given  at  exactly  the  time 
ordered,  not  half  an  hour  earlier  or  later,  unless 
the  patient  is  sleeping  and  is  not  to  be  dis- 
turbed, and  about  half  an  hour  should  be 
allowed  between  medicine  and  food.  Iron  and 
cod-liver  oil  are  amongst  the  medicines  given 
after  meals,  and  iron  must  be  taken  through  a 
tube  if  in  liquid  form,  as  it  is  injurious  to  the 
teeth.  When  a  course  of  iron  is  prescribed  it 
will,  as  a  rule,  be  found  very  constipating,  and 
a  laxative  of  some  kind  will  be  needed  every 
few  days.  Lemon  juice  taken  in  the  mouth 
before  and  after  a  disagreeable  dose,  or  chew- 
ing a  crust  of  bread  or  a  clove,  will  be  of  great 
assistance  in  removing  the  taste.  You  may 
sometimes  disguise  the  taste  of  medicine  alto- 
gether in  food  or  drink  of  some  kind  when  you 
have  a  delirious  patient  or  a  child  who  refuses 
to  take  it.  When  that  is  impossible  make  the 
dose  very  small  by  not  adding  much  water,  and 
compress  the  nostrils,  when  the  patient  will  be 


40  HOME  NUKSING 

obliged  to  open  his  mouth  for  breath,  and  you 
will  be  able  to  slip  the  medicine  down  his  throat. 

If  a  glass  stopper  refuses  to  come  out  of  a 
bottle,  it  can  generally  be  removed  by  holding 
under  very  hot  water  for  five  or  ten  minutes, 
or  by  allowing  a  few  drops  of  oil  to  stand 
around  the  stopper.  When  it  is  especially  ob- 
stinate, hold  it  over  the  flame  of  a  lighted 
match,  and  the  heat  will  soon  loosen  it.  Some 
people  find  it  very  difficult  to  swallow  pills. 
One  of  the  easiest  ways  to  manage  is  to  place 
the  pill  under  the  tip  of  your  tongue,  instead  of 
on  top  of  it,  take  a  drink  of  water,  and  the  pill 
will  disappear  like  magic!  If  you  prefer,  you 
may  crush  the  pill  into  powder  and  give  it  dry 
on  the  tongue,  or  roll  it  in  jam  or  bread. 
Other  people  object  to  powders,  and  this  may 
be  overcome  by  rolling  them  up  in  a  little 
gelatine  wafer.  Then  they  will  slip  down  the 
throat  easily.  These  wafers  may  be  bought  at 
any  druggists,  and  are  inexpensive  and  useful. 
Another  way  to  dispose  of  a  powder  is  to  dis- 
solve it  in  water,  and  when  it  does  not  mix 
well,  as,  for  instance,  trional  powder,  use  a 
little  glycerine  or  whiskey  first  to  moisten  it, 
then  add  the  water. 

Medicines  should  be    measured   very  care- 


MEDICINES  41 

fully,  as  with  some  drugs  even  a  drop  more  or 
less  will  make  a  great  difference.  The  gradu- 
ating glass  will  be  found  the  most  accurate  for 
measuring,  or  a  glass  dropper  with  a  rubber 
bulb  at  one  end,  when  the  dose  has  to  be 
measured  by  drops.  Children  need  much 
smaller  doses  of  medicine  than  adults,  and  the 
amount  must  be  regulated  according  to  their 
ages.  A  child  three  years  old  takes  one-sixth 
the  dose  of  an  adult.  One  teaspoonful  equals 
a  fluid  drachm,  and  a  tablespoonful  equals  half 
an  ounce.  In  giving  castor  oil,  it  is  very  easy 
to  disguise  the  taste  completely.  I  have  given 
it  in  orange  juice  to  a  child,  and  it  was  taken 
with  delight;  half  the  juice  poured  into  a 
glass,  then  the  oil,  and  afterward  the  remainder 
of  the  juice  on  top.  The  best  way  to  mix  it 
for  an  adult,  is  first  a  teaspoonful  of  whiskey 
in  the  glass,  then  a  little  cinnamon  water  or 
lemon  juice,  next  the  dose  of  oil,  generally 
a  tablespoonful,  followed  by  more  cinnamon 
water  and  another  spoonful  of  whiskey.  In 
this  way  it  is  impossible  to  taste  the  oil. 
Castor  oil  can  also  be  completely  disguised 
in  soda  water,  with  a  good  deal  of  flavoring. 
When  a  prescription  for  medicine  is  given 
by  a  doctor  it  is  always  well  to  ask  the  drug- 


42  HOME  NURSING 

gist  for  a  copy  of  the  prescription ;  you  will 
then  be  sure  that  you  are  getting  exactly  what 
has  been  ordered,  and  if  you  need  the  medi- 
cine renewed  at  any  time  when  away  from 
home,  you  have  the  prescription  to  which  to 
refer.  It  is  also  of  great  importance  some- 
times to  know  what  you  are  giving  or  taking 
in  the  way  of  medicine,  as  drugs  affect  people 
differently.  Some  patients  cannot  stand  even 
a  small  dose  of  certain  medicines.  I  know  of 
one  family,  no  member  of  which  can  take  the 
smallest  amount  of  opium  in  any  form,  without 
showing  signs  of  poisoning.  It  is  not  a  safe 
thing  to  prescribe  drugs  for  your  friends  with- 
out a  doctor's  direction,  except  in  the  most 
simple  household  remedies. 

A  lady  told  me  once  that  having  found  ten 
grains  of  phenacetine  very  helpful  when  she 
had  a  nervous  headache,  she  recommended  it 
to  her  sister  who  was  suffering  in  a  similar 
manner.  Shortly  after  taking  it  her  sister 
went  into  a  state  of  collapse,  and  it  was  hours 
before  she  recovered  from  the  effects.  They 
discovered  that  the  girl  had  some  heart 
trouble  entirely  unknown  to  herself  or  the 
family,  and  the  phenacetine  proved  too 
depressing. 


MEDICINES  43 

When  giving  medicine  put  it  into  a  small 
dainty  glass,  perfectly  clean,  with  a  glass  of 
ice  water,  and  a  piece  of  orange  or  lemon  on  a 
little  tray  covered  with  a  snowy  napkin,  and 
thus  by  making  the  dose  look  attractive,  you 
will  lighten  very  much  the  disagreeable  task 
of  taking  it. 


CHAPTER  III 

Preventions  of 
coughs  and  colds 

The  old-time  adage,  "  Prevention  is  better 
than  cure,"  if  remembered  and  acted  upon  a 
little  oftener  than  it  is,  would  save  a  world  of 
suffering  and  trouble. 

Take  for  instance  the  coughs  and  colds  that 
are  so  general  in  the  early  part  of  winter. 
When  the  weather  commences  to  change,  one 
of  the  family  is  sure  to  come  home  complaining 
of  feeling  chilly,  sick,  and  miserable,  with  ach- 
ing bones  and  all  the  first  symptoms  of  a  heavy 
cold.  In  nine  cases  out  of  ten,  no  immediate 
attention  is  paid  to  these  symptoms,  as  they 
are  considered  too  slight  to  be  "  doctored." 
Most  people  wait  until  the  cold  is  in  full  swing 
before  they  try  to  stop  it.  Instead,  if  a  little 
trouble  is  taken  at  the  beginning  to  prevent  it 
from  really  asserting  itself,  a  great  amount  of 
unnecessary  suffering  would  be  saved,  and  in 
some  cases  an  attack  of  bronchitis  or  pneu- 
monia avoided. 

44 


PREVENTIONS  OF  COUGHS  AND  COLDS   45 

I  have  heard  a  doctor  declare  that  it  is  next 
to  impossible  for  anybody  to  take  cold  if  the 
body  is  in  a  perfectly  healthy  condition  ;  the 
system  not  loaded  with  too  many  rich  foods, 
the  bowels  kept  in  good  order,  moving  regu- 
larly every  day,  and  a  certain  amount  of  exer- 
cise taken  daily  in  the  open  air,  which  last  is 
one  of  the  most  important  rules  of  health. 

Take  for  example  two  men  sitting  side  by 
side  in  an  office,  both  exposed  to  a  draught 
from  door  or  window  ;  one  goes  home  perfectly 
well,  and  the  other  with  all  the  symptoms  of  a 
heavy  cold.  If  you  make  inquiries  you  will 
find  that  one  man  took  good  care  of  himself, 
was  moderate  in  eating  and  drinking,  and  did 
not  neglect  a  daily  bath  and  plenty  of  exercise ; 
while  the  other  had  been  careless  in  some  way 
that  put  his  system  out  of  order. 

One  of  the  best  precautions  against  taking 
cold  is  the  plentiful  use  of  cold  water.  A 
good  plunge  bath  every  morning,  or  at  least 
sponging  the  throat,  arms,  and  chest  with  cold 
water  for  a  few  moments,  will  cause  the  blood 
to  circulate  freely  and  brace  up  the  system. 
Breathing  through  the  nose  instead  of  the 
mouth,  when  in  the  open  air,  will  often  prevent 
sore  throat.  Damp  skirts  and  wet  shoes  should 


46  HOME  NURSING 

be  changed  immediately,  and  if  the  feet  are 
cold  and  wet,  dip  them  into  cold  water  for  a 
minute,  and  rub  briskly  with  a  rough  towel. 
The  passages  of  the  nose  and  throat  should 
be  kept  thoroughly  cleared  so  that  the  air  can 
circulate  freely  through  them,  to  prevent  any 
clogging  that  might  cause  catarrh. 

As  to  wearing  flannels,  each  one  must  decide 
that  for  himself,  as  that  which  suits  one  person 
may  not  answer  for  his  neighbor.  The  "  linen 
mesh"  underwear  is  recommended  by  many 
doctors  as  the  healthiest  as  well  as  the  most 
comfortable  that  can  be  worn,  and  is  especially 
useful  where  there  is  any  pulmonary  weakness. 
We  all  know  that  sitting  in  a  draught  at  any 
time,  especially  when  overheated,  is  sure  to 
invite  a  cold,  and  yet  it  is  hard  to  keep  our 
friends  from  doing  it,  and  perhaps  more  diffi- 
cult still  to  keep  from  doing  so  ourselves. 

Care  of  coughs 
and  colds 

Once  the  symptoms  of  a  cold  really  establish 
themselves,  there  are  some  simple  remedies 
that  can  be  tried  to  overcome  it.  The  first 
thing  all  doctors  recommend  is  a  good  cathartic 
to  clear  out  the  system  and  reduce  the  feverish 


CARE  OF  COUGHS  AND  COLDS      47 

symptoms.  This  is  always  best  taken  at  night 
so  as  to  act  the  first  thing  in  the  morning. 
Almost  every  one  has  some  simple  home  rem- 
edy he  is  accustomed  to  use,  and  it  should  be 
followed  in  the  morning  by  a  Seidlitz  powder 
or  one  of  the  many  mineral  waters  in  general 
use.  With  children  a  dose  of  castor  oil  is  the 
safest  and  best  remedy  to  use,  especially  when 
there  is  any  sign  of  croup.  As  a  rule,  I  have 
found  that  calomel  acts  better  with  adults,  in 
overcoming  a  cold  ;  either  in  doses  of  one- 
tenth  of  a  grain  tablets,  two  taken  every  fifteen 
minutes  until  ten  or  twelve  have  been  con- 
sumed, or  one-quarter  grain  tablets,  one  every 
half-hour  for  four  doses.  Some  people  can 
stand  larger  doses  than  this,  but  as  a  rule  one 
grain  taken  in  the  small  doses  will  be  found 
quite  sufficient.  Calomel  should  always  be 
followed  in  a  few  hours  by  a  mineral  water  or 
salts  of  some  kind  to  prevent  its  resting  in  the 
system. 

When  there  are  any  feverish  symptoms  with 
the  cold,  as  headache,  flushed  cheeks,  skin  dry 
and  hot,  etc.,  a  hot  mustard  foot-bath  will 
draw  the  fever  down  from  the  head,  and  pro- 
mote free  perspiration.  After  the  foot-bath, 
tuck  your  patient  in  bed  and  give  him  a  hot 


48  HOME  NURSING 

drink  of  any  kind,  heat  being  the  principal 
object ;  either  milk,  bouillon,  lemonade,  or 
whiskey  and  water  (if  your  patient  does  not 
belong  to  the  temperance  society).  In  the 
morning  a  cold  sponge  over  arms  and  chest, 
and  a  generous  dose  of  mineral  water,  will 
often  be  the  final  touch  necessary  to  drive  the 
cold  out  of  the  system.  Camphor  taken  in  some 
form  at  the  very  beginning  of  a  cold  is  most 
helpful ;  it  can  either  be  taken  in  camphor 
pills  or  in  the  rhinitis  tablets  which  contain  a 
good  deal  of  camphor.  Spirits  of  camphor,  ten 
drops  on  a  lump  of  sugar,  or  in  a  little  water 
answers  nearly  as  well. 

Five  or  six  grains  of  quinine  taken  at  bed- 
time, and  again  in  the  morning,  is  also  of  great 
service  in  some  cases  in  the  commencement  of 
a  cold.  The  best  cough  mixture,  and  the  one 
that  is  now  most  extensively  used  by  physi- 
cians, is  a  preparation  of  creosote. 

Tonsilitis 

Inflammation  and  swelling  of  the  tonsils,  or 
an  ordinary  sore  throat,  will  soon  disappear 
with  the  use  of  a  gargle  made  from  peroxide 
of  hydrogen  mixed  with  water,  equal  parts  of 
both,  used  freely  every  one  or  two  hours.  A 


TONSILITIS  49 

friend  of  mine  declares  that  she  can  always 
cure  severe  sore  throat  in  twenty-four  hours 
with  this  gargle  used  constantly.  Inhaling 
menthol  is  also  of  great  service.  Sore  throat 
is  sometimes  caused  by  indigestion,  and  when 
this  is  the  case  a  good  dose  of  medicine  should 
be  taken. 

During  an  attack  of  tonsilitis  the  diet 
should  be  very  light.  Sometimes  it  is  neces- 
sary to  touch  the  tonsils  with  an  astringent, 
but  that  would  come  under  the  doctor's  treat- 
ment. A  cold  pack  made  by  wringing  a  hand- 
kerchief out  of  ice  cold  water  and  applied  to 
the  throat  at  bedtime,  a  small  mustard  paste 
or  an  application  of  capsicum  vaseline,  will 
draw  out  the  inflammation.  Little  pieces  of 
ice  mixed  with  glycerine,  and  allowed  to  melt 
in  the  mouth,  cool  the  throat  and  are  very 
soothing.  Should  your  patient  be  troubled 
with  a  disagreeable  little  tickling  in  the  throat, 
which  obliges  him  to  cough  incessantly,  espe- 
cially when  lying  down,  you  will  soothe  it  very 
much  by  the  use  of  glycerine  and  whiskey,  or 
glycerine  and  lemon  juice,  equal  parts,  adding 
a  little  water  if  the  whiskey  is  too  strong. 
This  mixture  is  taken  in  little  sips  and  allowed 
to  go  slowly  down  the  throat.  It  is  especially 


50  HOME  NURSING 

useful  at  night,  as  it  may  be  prepared  at  bed- 
time, and  kept  on  a  table  near  at  hand. 

When  suffering  from  sore  throat  the  throat 
should  be  kept  moist  by  frequent  drinks  of 
very  hot  or  ice  cold  liquids  (the  hot  drinks 
are  best),  or  by  using  some  cough  drops  and 
letting  them  dissolve  slowly  in  the  mouth.  A 
simple  but  useful  little  cough  mixture  is  made 
by  boiling  some  flaxseed  and  marsh-mallow  root 
together,  strain  carefully,  add  the  juice  of  half 
a  lemon,  and  sweeten  to  taste. 

Grippe 

During  the  past  fe,w  years  grippe  has  be- 
come so  universal  in  the  winter  season  that 
it  is  well  to  know  how  to  treat  it  when  it 
enters  the  family.  In  the  first  place  it  has 
been  proven  beyond  all  doubt  that  it  is  an 
infectious  disease,  and  even  in  some  instances 
has  been  also  contagious. 

To  prevent  it  spreading  through  the  house- 
hold you  must  keep  the  patient  apart  as  much 
as  possible  from  the  other  members  of  the 
family,  and  especially  guard  against  any  one 
inhaling  his  breath  or  sleeping  in  the  same 
room.  The  first  symptoms  of  grippe  are 
usually  severe  headache,  fever,  often  as  high 


GRIPPE  51 

as  102  or  103,  heavy  cold  in  the  head,  and  a 
very  tired,  depressed,  listless  feeling,  with 
aches  in  every  bone  in  the  body.  These  gen- 
eral symptoms  are  often  followed  by  various 
complications,  as  grippe  seems  to  have  the 
faculty  of  attacking  any  part  of  the  body 
that  is  at  all  weak  or  delicate. 

If  it  is  possible  to  do  so,  as  soon  as  the  first 
symptoms  appear,  put  the  sufferer  to  bed  and 
keep  him  warm  and  quiet  for  a  few  days,  and 
you  will  most  likely  be  able  to  prevent  the 
disease  going  further.  But  it  is  not  possible 
always  to  indulge  in  the  luxury  of  bed,  as 
those  engaged  in  business  often  feel  obliged 
to  keep  on  their  feet  until  the  last  moment, 

Almost  any  physician  nowadays  would  pre- 
scribe calomel  to  be  taken  at  the  beginning, 
in  the  way  I  have  already  described.  It  will 
go  far  toward  stopping  the  disease.  A  very 
hot  tub  bath  at  bedtime  is  most  soothing  to 
the  aching  bones,  hot  drinks  and  hot-water 
bags  at  the  feet,  and  some  counter  irritant,  as 
capsicum  vaseline,  oil  of  wintergreen,  or  vase- 
line and  turpentine  rubbed  on  wherever  there 
are  pains  and  aches,  will  be  of  great  assistance. 
When  there  is  intense  pain  in  any  locality, 
a  mustard  plaster  will  generally  soothe  it. 


52  HOME  NURSING 

Quinine  taken  in  two  or  three  grain  doses  every 
three  hours  acts  as  a  general  tonic.  Phenace- 
tine  and  salol,  two  and  a  half  grains  of  each 
in  tablet  form  taken  every  three  hours,  is  also 
most  helpful. 

Almost  every  one  has  some  pet  remedy  he 
prefers  to  try  before  calling  in  the  aid  of  a 
physician.  But  when  the  disease  does  not 
yield  to  simple  remedies,  you  must  perforce 
persuade  your  patient  to  take  a  holiday  from 
business,  and  to  spend  it  in  bed  or  confined 
to  one  room  for  a  few  days  under  the  doctor's 
directions.  Keep  the  room  at  an  even  tem- 
perature and  avoid  excitement  of  any  kind, 
the  bowels  opened  freely  every  day,  and  a 
simple  but  nourishing  diet  of  broth,  eggs,  rare 
beefsteak,  milk  in  any  form,  and  all  other 
easily  digested  foods.  A  tonic  of  some  kind 
helps  to  stimulate  the  appetite.  For  the  rest, 
following  out  the  doctor's  orders  carefully,  and 
a  complete  rest  of  mind  and  body  will  bring 
about  a  speedy  recovery.  So  many  compli- 
cations may  come  from  even  a  slight  attack  of 
grippe,  and  it  so  often  develops  into  bronchitis 
or  pneumonia,  that  you  cannot  be  too  prompt 
at  the  outset  in  checking  its  course. 

I   have  known  of   several  cases   of   chronic 


BRONCHITIS  53 

heart  disease  that  developed  after  an  attack 
of  grippe,  and  even  when  there  is  no  complica- 
tion, after  a  severe  attack  the  system  is  lia- 
ble to  remain  weak  and  delicate  for  months. 
Grippe  in  the  case  of  old  people  is  specially 
dangerous,  and  frequently  ends  in  pneumonia 
or  heart  failure.  For  this  reason  the  necessity 
of  preventing  the  disease  or  stopping  it  in  the 
very  beginning  cannot  be  too  strongly  en- 
forced. An  ordinary  cold  may  be  the  com- 
mencement of  a  very  sad  ending. 

Bronchitis 

Some  of  the  first  symptoms  that  appear  in 
a  case  of  bronchitis  are,  chill,  fever,  oppressed 
feeling  in  the  chest,  irritation  in  the  bronchial 
tubes,  which  causes  paroxysms  of  coughing, 
aching  limbs  and  head,  and  a  restless,  nervous 
condition  of  the  whole  body.  When  these 
symptoms  appear,  a  physician  should  be  sum- 
moned, and  his  directions  carefully  carried  out. 
One  of  the  important  things  to  be  watched 
during  an  attack  of  bronchitis  is  the  tem- 
perature of  the  room,  which  should  be  kept 
as  even  as  possible,  and  never  allowed  to  fall 
below  68°.  A  moist  atmosphere  is  of  great 
assistance,  and  this  can  be  accomplished  by 


54  HOME   NURSING 

a  kettle  of  water  kept  boiling  in  the  room 
night  and  day. 

Give  light  but  nourishing  food  every  two 
or  three  hours,  such  as  milk,  eggs,  oysters,  etc., 
and  during  convalescence  feed  the  patient  well. 
Be  sure  and  keep  the  feet  very  warm,  with  hot 
water  bags  and  bed  socks,  as  cold  feet  will  in- 
crease the  tendency  to  cough.  At  the  begin- 
ning of  the  attack  a  mustard  foot-bath  will  be 
found  most  soothing  and  restful,  and  also 
plenty  of  hot  drinks. 

During  the  first  few  days  there  is  generally 
a  paroxysm  of  coughing  in  the  very  early 
hours  of  the  morning,  because  during  sleep  mu- 
cus is  apt  to  collect  in  the  bronchial  tubes, 
and  cause  a  great  deal  of  irritation.  In  order 
to  stop  the  coughing,  raise  the  head  and  slip 
two  or  three  pillows  under  it,  give  a  drink 
of  hot  milk  with  a  dessertspoonful  of  glycerine, 
and  should  the  cough  continue,  half  a  teaspoon- 
ful  of  paregoric  will  soothe  it.  When  there 
is  great  oppression  and  difficulty  of  breathing, 
apply  a  mustard  paste  for  a  few  moments,  and 
give  the  patient  a  little  whiskey  and  water. 
Inhaling  steam  from  a  kettle  also  gives  the 
greatest  relief,  and  it  can  easily  be  managed 
by  surrounding  the  spout  of  the  kettle  with 


PLEURISY  55 

paper,  widening  it  out  at  the  upper  end  to 
cover  the  mouth  completely,  then  forming  a  tent 
over  the  patient's  head  with  a  sheet  and  letting 
him  inhale  the  steam  slowly  and  carefully. 

Talking  more  than  is  necessary  should  not 
be  allowed,  as  it  irritates  the  bronchial  tubes. 
Should  the  doctor  order  poultices  of  any  kind, 
make  them  very  light,  so  that  they  will  not 
weigh  heavily  on  the  chest.  Some  doctors 
advise  emetics  in  the  early  stages  of  bronchi- 
tis, and  if  the  breathing  becomes  very  difficult 
and  oppressed,  it  will  be  greatly  relieved  by 
the  use  of  oxygen. 

Pleurisy 

One  of  the  principal  symptoms  of  pleurisy  is 
a  sharp  pain  in  the  side,  which  is  felt  with 
every  breath.  The  disease  generally  starts 
with  a  chill  followed  by  fever,  and  there  is  a 
frequent  dry  cough.  The  respiration  increases 
very  rapidly. 

While  awaiting  the  physician's  arrival,  ap- 
ply a  linseed  poultice  or  mustard  paste  over 
the  seat  of  pain.  The  physician  will  prescribe 
a  regular  course  of  treatment,  and  the  same 
general  rules  for  nursing  are  to  be  followed, 
as  in  cases  of  bronchitis  or  pneumonia 


56  HOME  NURSING 

Pneumonia 

Pneumonia  is  generally,  but  not  always, 
ushered  in  with  a  chill,  high  fever,  with  head- 
ache, and  pain  in  the  chest  after  coughing. 
The  breathing  is  rapid,  and  the  pulse  gradually 
rises,  accompanied  by  intense  restlessness  and 
nervousness.  The  room  must  be  kept  cool 
(68°).  So  long  as  the  fever  is  high  keep  the 
patient  as  quiet  as  possible ;  no  visitors  should 
be  allowed  without  the  physician's  permission. 
A  fluid  diet,  given  every  two  hours  in  small 
quantities,  is  necessary  while  the  temperature 
remains  high.  The  stomach  is  often  weak  in 
pneumonia,  and  different  preparations  of  milk 
and  broth  have  to  be  tried  to  ascertain  what 
can  most  easily  be  retained. 

Give  the  nourishment  either  very  hot  or  ice 
cold,  as  anything  lukewarm  is  very  nauseating. 
Beef  juice  is  especially  useful  during  an  attack 
of  pneumonia,  as  it  provides  so  much  nourish- 
ment and  strength  in  a  concentrated  form,  and 
is  easily  digested.  Frequently  in  the  night, 
after  the  fever  breaks,  there  will  be  a  profuse 
perspiration,  and  the  night  clothes  become  cold 
and  clammy  with  moisture.  Remove  all  the 
damp  clothes,  rub  your  patient  quickly  with 
warm  towels  and  alcohol,  and  put  on  fresh 


PNEUMONIA  57 

clothes  well  aired  and  heated.  Nourishment 
is  needed  during  the  night,  and  especially  in 
the  early  morning  hours,  when  the  vitality  will 
be  found  very  low.  It  is  wiser  to  waken  your 
patient  for  nourishment  than  to  allow  him  to 
continue  sleeping  when  he  is  in  a  very  weak 
condition.  Keep  his  head  low,  and  on  no 
account  allow  him  to  get  out  of  bed  without 
the  physician's  orders,  for  fear  of  heart  fail- 
ure. 

If  the  temperature  rises  to  106°  or  107°  — 
ice  cold  baths  are  sometimes  given,  and  in 
some  cases  I  have  cared  for  they  have  had  a 
splendid  effect,  but  as  a  rule  they  are  only  re- 
sorted to  in  most  extreme  cases.  Frequent 
sponging  with  alcohol  and  water,  and  very  light 
covering  will  help  to  reduce  the  fever,  also 
plenty  of  cold  water  to  drink.  Recovery  de- 
pends greatly  on  faithful  nursing  and  constant 
care.  The  physician's  orders  must  he  strictly 
obeyed ;  and  it  will  assist  him  very  materially 
if  you  keep  a  little  record  of  the  case,  note  the 
temperature,  pulse,  and  respiration  every  three 
hours ;  the  character  and  frequency  of  the 
cough  and  expectorations ;  amount  of  food 
taken,  character  of  stools,  and  quantity  of 
urine  passed  in  twenty-four  hours  ;  and  any 


58  HOME  NURSING 

special  symptom  that  may  show  itself  during- 
the  physician's  absence. 

A  pneumonia  jacket  is  frequently  ordered, 
and  should  not  be  removed  while  there  is  the 
slightest  pain  or  tenderness  left,  and  when  it 
is  advisable  to  remove  it,  the  best  plan  is  to 
cut  off  an  inch  or  two  from  the  bottom  every 
day,  so  that  the  patient  wiJl  gradually  become 
accustomed  to  do  without  it. 

Insomnia 

Almost  every  one  encounters  a  period  in  his 
life  when  sleep  for  a  time  deserts  him,  either 
through  ill  health,  worry,  or  nervousness  ;  and, 
except  when  absolutely  necessary,  it  is  un- 
wise to  resort  to  sleeping  powders  or  drugs 
of  any  kind,  as  the  habit  of  taking  them  is 
easily  formed,  very  hard  to  overcome,  and  may 
become  a  deadly  foe  to  peace  of  mind  and  even 
life  itself. 

When  obliged  to  endure  real  physical  suffer- 
ing an  anodyne  or  narcotic  of  some  kind  is 
necessary;  but  when  sleeplessness  comes  from 
sheer  nervousness,  worry,  or  overtired  brain, 
there  are  various  little  experiments  that  have 
been  tried  and  have  proved  successful  in  pro- 
moting sleep.  Take  as  much  outdoor  air  and 


INSOMNIA  59 

exercise  as  possible,  and  do  not  allow  yourself 
to  sleep  during  the  day  or  after  dinner  in  the 
evening.  Avoid  all  mental  work  or  exciting 
reading  after  dinner. 

Prepare  for  retiring  about  10  P.M.,  by  tak- 
ing a  tub  bath  in  warm,  but  not  too  hot, 
water  for  about  ten  minutes.  Warm  water  is 
much  more  soothing  than  very  hot  water,  the 
latter  being  too  stimulating  for  repose.  After 
the  bath,  rub  the  body  briskly  with  a  flesh 
brush  or  rough  bath  towel;  then  get  right 
into  bed  while  the  body  is  in  a  glow  from  the 
rubbing,  and  the  nerves  relaxed  and  soothed 
by  the  warm  water. 

Something  hot  in  the  way  of  nourishment 
should  then  be  taken,  as  it  is  just  as  impossible 
to  sleep  when  the  stomach  is  empty  as  if  you 
had  overloaded  the  system  with  rich  food.  A 
little  hot  milk,  broth,  or  cocoa,  or  even  plain 
hot  water,  will  be  sufficient.  If  you  get  into 
the  way  of  sleeping  well  the  first  part  of  the 
night,  but  waking  about  four  o'clock  and  ly- 
ing awake  until  the  rising  bell  rings,  you  may 
be  able  to  overcome  this  bad  habit  by  taking 
some  nourishment  as  soon  as  you  wake. 

Some  people  require  food  much  oftener  than 
others,  as  their  digestive  organs  work  more 


60  HOME   NURSING 

rapidly,  and  so  they  may  wake  from  sheer 
hunger,  without  being  thoroughly  conscious  of 
the  fact.  A  lady  who  had  been  a  very  restless 
sleeper  told  me  that  she  overcame  the  habit  by 
slipping  the  pillow  out  from  under  her  head 
whenever  she  was  wakeful,  and  the  change  of 
position  invariably  put  her  to  sleep. 

Another  person's  remedy  when  wakeful  is  to 
get  up  and  rub  the  chest,  arms,  and  back  for  a 
few  moments  with  a  towel  wrung  out  of  cold 
or  lukewarm  water.  After  drying  briskly  with 
a  rough  towel  and  jumping  into  bed  again,  he 
is  asleep  in  five  minutes. 

A  cold  wet  cloth  applied  at  the  base  of  the 
brain,  and  covered  so  that  it  will  retain  its 
moisture,  is  of  great  assistance  when  the  brain 
is  overtired  and  unable  to  stop  working.  Some- 
times an  alcohol  rub  at  bedtime  will  invite  the 
wished-for  slumber  when  all  else  fails. 

However,  none  of  these  remedies  will  be  of 
the  slightest  avail,  unless  the  bedroom  is  prop- 
erly ventilated.  Sleep  taken  in  a  room  with- 
out having  a  window  open  a  few  inches,  will 
be  of  little  benefit,  as  you  will  awake  in  the 
morning  feeling  tired  and  unrefreshed.  It  is 
necessary,  even  in  winter,  to  have  good  venti- 
lation in  the  bedroom.  Opening  the  window 


INSOMNIA  61 

an  inch  is  sufficient,  and  with  the  bed  well  pro- 
tected from  draughts,  you  will  be  surprised  to 
find  how  rested  and  invigorated  you  will  feel 
in  the  morning.  If  you  are  accustomed  to 
sleep  with  some  one  else,  and  are  troubled  with 
insomnia,  try  sleeping  alone  for  a  few  nights  ; 
it  is  much  more  restful. 

Children  should  on  no  account  be  allowed  to 
sleep  with  older  people,  as  much  of  the  child's 
strength  will  be  absorbed  by  the  adult.  Deli- 
cate or  nervous  people  should,  if  possible,  al- 
ways sleep  alone.  Where  it  is  really  necessary 
to  resort  to  a  sleeping  powder,  "  Trional "  is 
the  most  harmless  that  can  be  used,  and  it 
leaves  no  bad  after  effects.  About  ten  grains 
taken  with  hot  milk,  or  hot  water,  will  give 
some  hours  of  refreshing  slumber,  but  it  is 
wiser  to  consult  a  physician  before  using  sleep- 
ing medicines  of  any  description. 

A  friend  of  mine  who  has  suffered  a  great 
deal  from  insomnia  declares  that  the  moral 
effect  of  having  a  sleeping  powder  on  the  table 
beside  her  ready  for  use,  should  she  need  it,  is 
frequently  sufficient  to  cause  her  to  sleep  peace- 
fully. Children  require  a  great  deal  of  sleep, 
especially  when  they  are  of  a  nervous  dispo- 
sition and  are  growing  rapidly.  They  should 


62  HOME   NURSING 

always  be  put  to  bed  very  early  in  the  evening, 
at  a  regular  hour  every  night,  as  the  best  sleep 
is  that  which  comes  before  midnight. 

Indigestion  is  one  of  the  chief  causes  of  in- 
somnia in  children,  and  some  of  them  require 
an  additional  supply  of  warmth.  Cold  feet 
will  keep  them  awake,  as  it  often  does  older 
people.  If  their  feet  are  cold  at  bedtime,  a  hot 
foot-bath  and  a  pair  of  bed  socks  will  soon 
remedy  this  trouble.  Music  is  a  great  hyp- 
notic with  children,  even  after  they  have  out- 
grown their  babyhood,  and  a  simple  little  story 
told  to  them  in  a  monotonous  voice  without 
any  exciting  adventures  will  prove  sufficient 
to  enwarp  even  the  most  wakeful  child  in  "  Na- 
ture's sweet  restorer  balmy  sleep." 


CHAPTER  IV 

Baths 

If  every  one  understood  thoroughly  how 
helpful  baths  are  in  the  prevention  of  disease, 
as  well  as  how  much  they  add  to  bodily  com- 
fort, he  would  never  be  satisfied  to  omit  the 
daily  bath,  in  health  and  sickness.  A  daily 
bath  is  necessary  to  keep  the  pores  of  the  skin 
open,  and  remove  the  waste  material  from  the 
blood  that  is  brought  to  the  surface  by  numer- 
ous little  sweat  glands.  The  man  who  boasted 
that  water  had  not  touched  his  back  for  forty 
years,  must  have  been  loathsome  to  himself  and 
all  his  neighbors. 

A  bath  once  a  week,  usually  on  Saturday 
nights,  was  considered  by  our  grandmothers 
to  be  all  that  any  one  could  demand  in  the  way 
of  cleanliness.  But  in  this  progressive  age  we 
are  learning  the  great  importance  of  the  daily 
bath,  if  we  desire  to  keep  our  bodies  in  per- 
fect condition.  In  times  of  sickness  thorough 
cleanliness  is  a  positive  aid  to  recovery,  and 
we  all  realize  what  a  good  moral  effect  is  pro- 
63 


64  HOME  NURSING 

duced  when  we  emerge  from  a  tub-bath,  con- 
scious that  we  are  as  clean  as  soap  and  hot 
water  can  make  us. 

Gold  baths 

Cold  water  baths  should  always  be  taken  in 
the  morning  before  breakfast,  and  hot  ones  in 
the  afternoon  or  evening,  as  the  cold  water 
braces  up  the  system,  while  the  hot  water  re- 
laxes it  so  much  that  one  is  liable  to  take  cold 
if  exposed  to  the  outside  air  immediately  after- 
ward. If  possible,  a  cold  plunge  bath  should 
be  taken  in  the  morning  after  rising.  A  quick 
plunge  in  the  water,  and  a  brisk  rubbing  down 
with  a  flesh  brush  or  rough  towel,  will  bring 
the  blood  to  the  surface,  and  cause  a  fine  glow 
over  all  the  body. 

Should  the  cold  plunge  be  impossible  (and 
for  some  persons  it  is  too  great  a  shock  to  the 
system),  substitute  a  thorough  sponging  of  the 
neck,  arms,  and  chest  for  five  minutes,  allow- 
ing the  sponge  to  rest  for  a  few  seqonds  on  the 
back  of  the  neck  which  will  strengthen  the 
eyes.  A  very  good  suggestion  in  regard  to 
cold  baths,  is  to  draw  the  water  for  the  bath 
in  the  evening,  allowing  it  to  stand  all  night 
in  the  tub,  thus  removing  the  severe  chill  from 


HOT  BATHS  65 

the  water,  and  being  enabled  to  jump  right 
into  the  tub  on  entering  the  bath-room,  with- 
out being  obliged  to  wait  in  the  cold  until  the 
bath  is  ready.  You  will  find  nothing  more 
refreshing  and  invigorating  than  the  use  of 
cold  water  for  the  morning  ablutions ;  it 
hardens  the  system  and  is  one  of  the  greatest 
safeguards  against  colds.  Even  when  a  cold 
bath  is  taken  each  morning,  a  hot  bath  is 
necessary  once  or  twice  a  week,  to  remove 
the  natural  grease  from  the  body,  and  to  keep 
it  perfectly  clean.  Some  modern  authorities 
recommend,  instead  of  the  cold  bath,  a  tepid 
one,  with  a  cold  shower  bath,  or  sponging  off 
with  cold  water  afterward. 

Hot  baths 

There  is  a  great  difference  between  a  tepid 
bath  and  a  really  hot  one  :  the  former  is  much 
more  soothing  than  the  latter  ;  but  the  very 
hot  water  is  better  for  thorough  cleanliness, 
with  plenty  of  Castile  soap  and  occasionally  a 
little  ammonia  added,  to  make  the  skin  firm  and 
white,  and  to  remove  all  disagreeable  odors 
arising  from  perspiration.  After  taking  a  hot 
bath  it  is  a  good  plan  to  turn  on  the  cold  water 
tap  for  a  few  moments,  before  leaving  the  bath- 


66  HOME  NUKSING 

tub,  so  that  the  body  may  cool  oft  slowly  before 
being  exposed  to  the  air.  The  skin  must  al- 
ways be  rubbed  thoroughly  dry  before  dress- 
ing. A  celebrated  physician  affirms  that  almost 
the  greatest  benefit  of  the  bath  is  to  be  derived 
from  the  rubbing,  as  the  friction  thus  caused 
makes  the  blood  flow  freely  through  every  por- 
tion of  the  body.  One  strict  rule  should  always 
be  observed,  viz.  never  take  a  bath  of  any  kind 
immediately  after  eating,  as  it  will  check  di- 
gestion and  upset  the  whole  system.  I  can 
speak  from  experience  about  this,  as  once  I 
foolishly  took  a  hot  bath  immediately  after 
eating,  thinking  that  because  I  had  taken  a 
very  light  meal,  it  would  not  injure  me ;  but 
the  next  day  I  suffered  agonies  from  a  severe 
sick  headache  and  nausea,  which  taught  me  a 
lesson  I  shall  never  forget. 

At  least  one  hour  and  a  half  or  two  hours 
must  elapse  between  eating  and  bathing.  Any 
one  subject  to  headache  should  wet  the  fore- 
head with  cold  water  before  getting  into  the 
bath-tub.  When  hot  baths  are  taken  every 
day,  it  is  well  to  omit  the  bath  one  day  in  the 
week,  because  if  continued  without  interrup- 
tion, it  may  prove  rather  weakening  to  the 
system,  unless  the  bath  does  not  last  more  than 


BATHS   IN  BED  67 

ten  or  fifteen  minutes,  and  is  followed  by  a 
brisk  sponging  with  cold  water. 

Baths  in  bed 

During  sickness  an  extra  need  exists  for  the 
use  of  soap  and  water,  specially  when  there  is 
any  high  fever,  as  the  pores  of  the  skin  need 
to  be  kept  open.  The  daily  bath  is  also  most 
refreshing  and  stimulating  when  the  system  is 
weakened  with  sickness ;  beside  this  the  mus- 
cles have  no  chance  of  working  while  lying  in 
bed,  so  that  a  little  brisk  rubbing  each  day 
after  the  bath  will  be  found  to  be  of  great 
service  in  keeping  them  in  good  shape. 

Before  giving  a  bath  in  bed,  you  should  have 
everything  needful  at  hand,  so  that  you  need 
not  stop  in  the  middle  of  the  bath,  leaving  your 
patient  half  dried,  while  you  run  for  extra 
towels,  clothing,  or  other  necessaries.  If  you 
intend  putting  on  a  clean  nightgown  or  under- 
vest,  hang  them  over  a  chair  in  front  of  the 
fire  or  register  so  that  they  shall  not  chill  the 
patient.  Should  he  be  weak  or  liable  to  take 
cold  easily,  have  a  hot  water  bag  filled  ready 
to  apply  to  the  feet,  and  be  careful  that  the 
room  is  warm  and  with  no  draughts  that  would 
be  likely  to  reach  the  bed.  Place  a  chair  or 


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small  table  ready  for  the  basin  which  is  to  be 
filled  with  very  hot  water,  and  a  little  extra 
hot  water  should  be  on  hand,  as  it  is  apt  to 
cool  very  quickly  in  a  large  wide  basin.  Two 
wash  cloths  are  better  to  use  than  sponges,  one 
for  the  upper  and  one  for  the  lower  parts  of 
the  body,  also  a  bath  towel  and  a  couple  of  soft 
ones  for  the  face  and  hands.  Castile  soap  is 
the  best  and  purest,  and  a  little  alcohol  or  salt 
in  the  water  will  be  found  very  refreshing 
and  is  a  safeguard  against  colds. 

When  all  is  quite  ready  and  the  room  warm 
and  comfortable,  remove  your  patient's  cloth- 
ing and  place  him  between  two  blankets,  or,  if 
you  prefer  it,  use  one  blanket  over  and  the 
bath  towel  underneath  the  portion  of  the  body 
you  are  washing,  moving  it  from  one  side  to 
the  other  as  you  work. 

The  face  is  bathed  first,  then  the  neck,  arms, 
chest,  and  abdomen  ;  turn  the  patient  on  one 
side  and  bathe  the  back,  and  finish  with  the 
legs  and  feet.  Do  not  uncover  the  body  more 
than  is  necessary  to  wash  each  particular  por- 
tion. Dry  each  part  carefully  as  soon  as  you 
wash  it,  remove  the  towels  and  blankets,  and 
put  on  the  fresh  warm  clothing.  If  the  bath 
has  proved  exhausting,  give  a  drink  of  hot 


FOOT-BATHS  69 

milk,  broth,  or  an  eggnog.  After  the  bath, 
always  clean  the  finger  and  toe  nails,  and  brush 
the  hair. 

A  bath  in  bed  given  according  to  these  di- 
rections will  only  take  at  the  outside  from 
fifteen  to  twenty  minutes,  and  will  prove  of 
great  comfort  to  the  invalid.  Between  ten 
and  eleven  o'clock  in  the  morning  is  the  best 
time  for  a  bath,  but  it  can  be  given  before 
breakfast  if  desired. 

When  the  water  is  hard,  you  can  soften  it 
by  adding  a  little  borax.  It  is  surprising  how 
many  people  there  are  in  the  world  who  are 
afraid  of  the  touch  of  water,  hot  or  cold, 
and  some  patients  I  have  met  decidedly  object 
to  having  a  bath  in  bed  for  fear  of  any  expos- 
ure that  may  give  them  cold.  But  as  a  matter 
of  fact  there  need  not  be  any  exposure  of  the 
person,  as  the  whole  bath  can  be  given  under 
cover  of  the  blankets,  and  when  one  is  per- 
suaded to  have  a  bath,  he  is  quite  surprised  at 
the  ease  with  which  it  can  be  given,  and  the 
comfort  and  refreshment  resulting. 

Foot-baths 

During  an  illness,  when  there  is  severe  head- 
ache and  restlessness,  and  the  feet  are  cold,  a 


70  HOME  NURSING 

hot  foot-bath  will  be  found  very  soothing  and 
quieting  to  the  nerves.  It  can  easily  be  given 
even  when  the  patient  is  unable  to  leave  the 
bed.  Fill  the  foot-tub  half  full  of  water,  and, 
turning  up  the  bedclothes  from  the  feet  to  the 
knees,  place  the  foot-tub  on  the  bed,  bend  the 
knees  up,  and  put  the  feet  into  the  water, 
covering  the  feet  and  legs  with  a  double 
blanket.  The  water  must  be  as  hot  as  can 
be  borne,  and  the  bath  should  last  for  about 
twenty  minutes. 


Mustard 
foot-bath 


Where  there  is  a  good  deal  of  fever,  and 
the  head  is  very  hot  and  heavy,  as  in  fever 
cases,  sunstrokes,  bronchitis,  and  sometimes 
in  grippe,  a  mustard  foot-bath  is  frequently 
ordered  by  the  physician.  A  high  pail  or  foot- 
bath is  filled  with  very  hot  water,  and  the 
amount  of  mustard  used  varies  according  to 
the  age  of  your  patient.  For  an  adult  about  a 
tablespoonful  of  mustard  to  every  gallon  of 
water  is  the  usual  quantity.  The  water  should 
reach  almost  to  the  knees.  Cover  the  patient's 
legs  and  the  tub  with  heavy  blankets  to  pro- 
mote perspiration  ;  for  the  same  reason  a  hot 


BATHS  FOR  REDUCING  TEMPERATURE   71 

drink  should  be  taken  while  the  bath  goes  on. 
Add  hot  water  every  few  moments  to  keep  up 
the  temperature,  and  at  the  end  of  twenty 
minutes,  dry  the  feet  gently,  roll  them  in  a 
blanket,  and  put  your  patient  back  to  bed. 

Sponge  baths  for 
reducing  temperature 

When  caring  for  a  typhoid  fever  case,  in  a 
private  house,  the  regular  hospital  tub  bath  is 
seldom  given,  as  it  is  not  possible  to  have  all 
the  appliances,  including  a  bath-tub  on  wheels, 
so  that  a  sponge  bath  is  generally  substi- 
tuted. These  sponge  baths  should  be  given 
as  quietly  as  possible  so  that  the  patient  may 
not  be  disturbed  more  than  is  absolutely  neces- 
sary. A  foot-bath  or  pail  is  half  filled  with 
water  at  the  temperature  of  70°,  and  pieces  of 
ice  are  added  to  the  water  as  soon  as  the  tem- 
perature rises.  A  bath  thermometer  is  neces- 
sary to  be  sure  that  the  water  keeps  at  or 
below  70°.  Two  large  sponges  and  a  rubber 
sheet  to  protect  the  bed  are  required.  Place 
the  rubber  with  a  sheet  over  it  under  the 
patient,  remove  the  nightgown  and  cover  with 
a  sheet ;  then  put  a  rolled-up  blanket  under 


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the  edge  of  the  rubber  at  each  side  of  the  bed, 
thus  forming  a  hollow  space  around  the  body, 
and  it  will  prevent  the  water  from  dripping 
over  the  mattress.  Wring  out  a  towel  from 
the  ice  water  to  cover  the  head  (but  do  not  let 
it  drip  into  the  ears),  and  another  to  cover  the 
abdomen,  and  change  them  every  three  minutes 
to  keep  them  cold.  Sponge  the  arms  and  chest 
first,  with  long  even  strokes,  changing  the 
sponge  after  every  fourth  stroke,  and  use 
plenty  of  water.  After  the  arms  and  chest 
turn  the  patient  gently  on  one  side  and  sponge 
the  back,  then  the  legs.  About  five  minutes 
should  be  given  to  each  part  except  the  legs, 
which  do  not  require  so  much  sponging  as  they 
grow  cold  quicker  than  the  rest  of  the  body. 

Never  under  any  circumstances  rub  or  sponge 
the  abdomen  in  typhoid  fever,  as  there  would 
be  great  danger  of  hemorrhage  or  perforation. 
Exposure  to  the  air  will  not  hurt  the  patient, 
and  will  reduce  the  temperature  much  more 
quickly  than  if  you  keep  all  the  body  covered 
during  the  bath.  A  sponge  bath  of  this  kind 
should  last  about  fifteen  or  eighteen  minutes, 
and  plenty  of  cold  water  to  drink  ought  to 
be  given  during  the  bath  to  cool  off  the  in- 
side of  the  body.  Then,  wrap  the  patient 


SALT  BATHS  73 

in  a  blanket  for  ten  minutes,  to  rest  before 
replacing  the  clothing.  Some  doctors  have  a 
wet  sheet  wrapped  around  the  patient  and  cov- 
ered with  blankets  for  half  an  hour  after  the 
bath,  before  replacing  the  nightgown. 

The  temperature  should  be  taken  by  rectum 
before,  and  half  an  hour  after  the  bath  to 
prove  exactly  how  much  it  has  been  reduced. 
As  a  rule  stimulant  of  some  kind  is  ordered 
before  or  after  the  bath.  Of  course  these 
baths  should  never  be  attempted  without  the 
doctor's  orders,  and  they  are  usually  given 
under  his  directions,  as  there  are  many  cases 
where  the  heart  is  weak  and  they  would  prove 
too  exhausting  to  the  patient.  When  the 
fever  is  not  very  high,  and  it  is  only  necessary 
to  give  a  light  sponge  bath,  use  alcohol  and 
water,  or  vinegar  and  water,  temperature  about 
80°  with  a  little  ice  in  the  water  and  two  pieces 
of  gauze  instead  of  sponges.  Do  not  uncover 
the  patient,  but  slip  your  hand  under  the  sheet 
and  go  over  each  part  in  a  slow,  gentle  manner, 
and  your  patient  will  be  soothed  and  rested. 

Salt  baths 

Salt  baths  are  of  great  tonic  value,  especially 
in  nervous  cases,  and  they  can  be  given  either 


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hot  or  cold.  About  one-quarter  of  a  pound  of 
rock  salt  to  every  gallon  of  water  is  the  amount 
used.  Salt  and  alcohol  mixed  well  together 
and  rubbed  into  the  body,  commencing  with 
the  feet  and  working  upwards,  act  most  suc- 
cessfully in  restoring  the  nervous  system  after 
a  long  illness. 

Hot  baths 

Very  hot  tub  baths  are  sometimes  given 
during  illness,  to  cause  profuse  perspiration. 
The  temperature  of  the  water  may  be  as  high 
as  98°,  and  slowly  increased  until  as  hot  as 
the  patient  can  stand  it. 

Cold  cloths  must  be  kept  on  the  head,  and 
after  the  bath  wrap  the  patient  in  blankets, 
and  give  plenty  of  hot  water  to  drink.  The 
blankets  are  left  on  for  about  an  hour,  then 
the  body  rubbed  dry,  and  a  refreshing  sleep 
will  follow.  When  there  is  any  eruption  on 
the  skin,  such  as  prickly  heat,  hives,  or  a  skin 
affection  of  any  kind,  especially  during  the  hot 
weather,  washing  the  body  gently  with  bicar- 
bonate of  soda  mixed  in  warm  water  will 
relieve  the  irritation  immensely.  Bisulphide 
of  soda  is  also  used  frequently  for  the  same 
purpose.  When  giving  a  bath  to  a  very  stout 


BATH  MITTENS  — CHAPPED   HANDS  75 

person  wash  carefully  under  the  breasts  be- 
tween the  folds  of  the  groins  and  the  thighs, 
and  powder  well  afterward,  because  if  mois- 
ture is  allowed  to  remain  in  these  places  the 
skin  will  become  raw  and  irritated. 

Bath  mittens 

For  giving  oneself  a  good  stiff  rub  with  soap 
and  water  I  find  nothing  so  useful  as  a  pair 
of  bath  mittens.  They  are  made  from  Turkish 
towelling  cut  in  the  shape  of  two  bags  with 
elastic  around  one  end ;  the  hands  are  slipped 
in  and  the  elastic  prevents  the  mittens  from 
falling  off,  so  that  every  part  of  the  body  can 
be  well  rubbed  with  ease  and  comfort.  Some 
of  these  mittens  are  made  with  a  little  pocket 
inside  to  keep  the  soap  in  place.  Horsehair 
gloves  are  also  of  good  service  for  rubbing 
oneself  before  bathing,  especially  during  the 
cold  weather. 

Chapped  hands 

When  caring  for  a  patient  during  cold 
weather  it  is  very  trying  and  irritating  to  have 
your  hands  rough  or  hard  to  the  touch.  The 
following  recipe,  if  applied  after  the  hands  are 
washed,  will  keep  them  in  good  order,  and 


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remove  the  roughness  caused  by  the  use  of 
alcohol  or  when  obliged  to  have  your  hands 
continually  in  a  disinfectant  solution.  Equal 
parts  of  bay-rum,  glycerine,  borax,  and  spirits 
of  camphor  well  mixed  together. 

Mouth  wash 

Almost  every  patient  needs  a  good  mouth 
wash  after  eating,  especially  when  on  a  milk 
diet;  when  lying  in  bed  the  digestion  is  fre- 
quently out  of  order  from  want  of  exercise, 
and  causes  a  disagreeable  taste  in  the  mouth. 
Glycerine,  borax,  lemon  juice,  and  ice  water 
mixed  together  make  a  pleasant  and  useful 
mouth  wash.  Should  your  patient  be  too  sick  to 
use  a  mouth  wash,  twist  a  piece  of  cotton  wool 
or  old  linen  on  the  end  of  a  long  pencil,  dip  it 
in  the  mixture  and  gently  wash  off  the  gums  on 
both  sides,  and  the  tongue,  doing  it  very  cau- 
tiously so  as  not  to  cause  nausea.  In  all  fever 
cases,  specially  typhoid,  the  mouth  must  be 
.  carefully  watched,  and  rinsed  or  washed  every 
three  hours,  or  it  will  become  very  sore  and 
swollen,  and  a  brown  crust  will  form  over  the 
tongue  and  gums. 


CARE  OF  THE  TEETH  7T 

Dare  of  the  teeth 

The  teeth  ought  to  be  brushed  twice  a  day  in 
health  and  at  least  once  in  sickness.  This  is 
almost  more  necessary  at  night  than  in  the 
morning,  as  small  pieces  of  food  remaining 
from  the  last  meal  might  lodge  in  the  teeth  all 
night  and  soon  lead  to  decay.  It  is  not  wise  to 
use  a  very  stiff  tooth-brush  as  it  has  a  tendency 
to  loosen  the  gums  around  the  teeth.  Always 
brush  from  the  upper  gum  downwards,  and  up- 
wards from  the  lower  gum,  so  that  the  gums 
will  not  be  pushed  away  from  the  teeth.  A 
dentist  told  me  that  many  people  injure  their 
teeth  by  brushing  too  hard  and  in  a  wrong  di- 
rection, as  the  gums  recede  and  leave  the  sensi- 
tive bone  exposed. 

One  of  the  simplest  and  purest  tooth  pow- 
ders, the  recipe  for  which  was  given  to  me  by 
a  first-class  dentist,  is  :  equal  parts  of  cam- 
phorated chalk  and  orris  root,  with  one-third 
the  amount  of  bicarbonate  of  soda,  all  well 
mixed  together. 

After  a  long  illness,  or  when  troubled  with 
indigestion,  black  heads  or  little  pimples  often 
appear  on  the  face  and  are  most  irritating  and 
hard  to  get  rid  of.  A  simple  little  wash  made 
of  one  pint  of  rose  water  and  one  teaspoonful 


78  HOME  NURSING 

of  pure  95  per  cent  carbolic  is  most  cleansing 
and  very  effective  in  removing  the  pimples. 
The  rose  water  must  be  heated  so  as  to  melt 
the  oil  in  the  carbolic,  and  the  wash  is  applied 
at  bedtime. 


CHAPTER    V 

Fevers 

When  a  contagious  fever  enters  the  house- 
hold, it  is  sometimes  very  difficult  to  know  just 
from  where  the  infection  has  come,  as  we  daily 
run  the  risk  of  encountering  it  while  travelling 
in  street  cars  or  trains,  and  also  in  large  public 
gatherings. 

Infection 

As  a  rule,  people  are  not  half  so  particular 
as  they  ought  to  be,  often  going  out  of  an  in- 
fected room  or  house  into  a  crowded  convey- 
ance or  public  building,  without  proper  change 
of  clothing.  They  thus  carry  numerous  germs 
in  the  folds  of  their  garments,  and  these  germs 
are  ready  to  fasten  themselves  on  any  one  whose 
system  is  out  of  order,  and  consequently  liable 
to  contract  disease. 

Many  cases  of  contagious  fever  could  be 
traced  in  this  manner,  and  where  there  is  the 
remotest  chance  of  causing  suffering  and  per- 
haps death  to  other  people,  we  cannot  be  too 
careful  or  particular  as  to  what  means  we  take 
to  prevent  it.  Some  doctors  have  linen  coats 
70 


80  HOME   NURSING 

or  suits  that  they  leave  at  the  house  of  a  patient 
where  there  is  a  contagious  disease,  and  slip 
them  on  over  their  cloth  suits  before  entering 
the  sick-room.  It  is  certainly  a  wise  precau- 
tion when  they  are  obliged  to  go  from  one 
patient  to  another.  The  fever  germs  take  root 
in  the  human  body  just  as  seed  will  in  the  soil, 
and  develop  gradually,  between  five  and  ten 
days  elapsing  before  the  disease  shows  itself. 

Some  fevers  are  contagious  without  being 
infectious,  that  is,  they  can  only  be  contracted 
when  in  direct  communication  with  the  patient, 
as  in  cases  of  typhoid  fever,  malaria,  pulmo- 
nary tuberculosis,  etc. 

There  are  others  that  are  both  contagious 
and  infectious,  that  is,  they  can  be  carried 
through  a  third  person,  in  the  clothing,  or  by 
books,  letters,  or  other  personal  belongings; 
such  as  scarlet  fever,  smallpox,  diphtheria, 
measles,  etc. 

Some  fever  germs  are  carried  in  milk  and 
water,  more  especially  typhoid,  tuberculosis, 
and  diphtheria.  Typhoid  germs  have  been 
found  in  butter,  oysters,  water-cress,  ice-cream, 
etc.  When  there  is  a  suspicion  of  these  fevers 
being  in  the  neighborhood,  the  water  and  milk 
ought  always  to  be  sterilized  before  using. 


SYMPTOMS  81 

Symptoms 

In  almost  all  cases  of  fever,  the  patient  feels 
sick  and  miserable  for  two  or  three  days  before 
the  disease  really  declares  itself.  He  generally 
suffers  from  headache,  nausea,  aching  limbs 
and  back,  and  is  in  a  depressed  condition 
mentally. 

In  typhoid  fever  the  first  symptoms  are  a 
severe  continued  headache  and  backache,  a 
tired  listless  feeling  ;  sometimes  nose  bleed, 
and  a  rise  in  temperature  every  evening  a  little 
higher  than  the  day  before,  although  it  may  be 
normal  in  the  mornings.  Malarial  fever  is 
diagnosed  by  the  heavy  chills  and  fever,  re- 
turning at  regular  intervals. 

Scarlet  fever  does  not  declare  itself  decidedly 
until  the  rash  appears,  when  it  is  easily  distin- 
guished from  other  eruptions,  as  it  is  of  a 
bright  red  color  and  disappears  on  pressure ; 
it  first  shows  itself  on  the  face  and  neck  and 
around  the  joints.  Sore  throat  is  also  one  of 
the  first  symptoms  of  scarlet  fever. 

In  smallpox  the  rash  first  appears  around  the 
roots  of  the  hair  in  raised  spots  called  papules, 
and  soon  spreads  all  over  the  body.  The 
papules  increase  in  size  until  about  the  eighth 
day,  when  they  break.  Pus  runs  from  them 


82  HOME  NURSING 

and  forms  scabs  which  gradually  dry  and  dis- 
appear. Smallpox  is  easily  mistaken  at  first 
for  chicken-pox,  as  the  rash  in  both  cases  is 
very  much  alike  for  the  first  few  hours. 

Diphtheria  starts  with  a  chill,  fever,  and 
sore  throat.  The  diphtheritic  membrane  which 
forms  on  the  tonsils,  palate,  and  baok  of  the 
throat  is  of  a  grayish  white  color,  and  forms 
in  patches.  The  tonsils  are  very  much  swollen, 
and  there  is  great  difficulty  in  swallowing,  and 
a  very  offensive  breath. 

Measles  come  with  a  rash  formed  in  crescent- 
shaped  patches,  first  appearing  about  the  neck 
and  face,  with  a  copious  discharge  from  the 
eyes  and  nose,  and  there  is  generally  a  slight 
cough. 

As  this  little  book  is  only  intended  to  be  a 
guide  and  help  in  home  nursing,  I  will  not 
enter  fully  into  all  the  symptoms,  or  the  treat- 
ment of  fever  cases  ;  but  as  soon  as  any  of  the 
above-mentioned  symptoms  appear,  a  physician 
must  be  summoned  and  all  his  directions  care- 
fully carried  out. 

Isolation 

In  all  cases  of  fever  strict  isolation  must  be 
enforced  for  the  benefit  of  outsiders,  as  well  as 


CONTAGION  83 

for  the  safeguard  of  the  different  members  of 
the  family.  And  even  when  the  fever  is  only 
contagious  and  not  infectious,  it  is  necessary 
to  keep  the  patient  apart  from  other  people. 
When  it  is  advisable  to  nurse  the  sick  one  at 
home  through  a  contagious  disease,  put  him  in 
a  room  at  the  top  of  the  house  or  as  far  from 
the  other  members  of  the  family  as  possible. 

Take  up  the  carpet,  remove  the  curtains,  and 
all  upholstered  furniture,  and  leave  nothing  in 
the  room  that  might  be  hurt  by  the  daily  use 
of  disinfectants.  A  great  deal  can  be  done  to 
prevent  the  spread  of  disease  by  the  careful  use 
of  disinfectants. 

When  the  fever  is  smallpox  or  malignant 
scarlet  fever,  hang  over  the  door  of  the  room  a 
sheet  wrung  out  of  a  solution  of  ^V  carbolic, 
made  by  adding  one  part  of  pure  carbolic  acid 
to  twenty  parts  of  water. 

Thorough  cleanliness  and  good  ventilation 
will  go  far  toward  preventing  the  spread  of 
disease. 

Contagion 

Children  are  particularly  susceptible  to  con- 
tagion, and  should  be  at  once  sent  out  of  the 
house  when  an  infectious  disease  appears. 


84  HOME   NURSING 

In  the  olden  times,  it  was  considered  almost 
a  necessary  part  of  a  child's  life  to  go  through 
the  various  stages  of  measles,  scarlet  fever, 
whooping  cough,  etc.,  with  the  mistaken  idea 
that  every  child  was  obliged  to  have  these 
diseases  at  some  time  in  his  life,  and  so  had 
better  get  over  them  while  young.  Therefore 
they  were  not  kept  out  of  the  way  of  infection 
as  carefully  as  they  ought  to  have  been. 

But  we  have  learned  wisdom  in  these  days 
of  scientific  pathology,  and  we  know  that  it  is 
much  wiser  and  safer  to  keep  children  out  of 
the  way  of  infection  than  let  them  run  the 
risk  of  so  much  suffering  and  danger.  It  may 
not  be  generally  known  that  whooping  cough, 
which  is  called  a  child's  disease,  can  be  con- 
tracted by  older  people ;  but  I  lately  heard  of 
two  cases  where  old  ladies  took  this  distressing 
disease  from  their  grandchildren  and  had  very 
severe  attacks. 

Smallpox  is  contagious  even  before  the  dis- 
ease shows  itself,  while  measles  and  whooping 
cough  are  most  contagious  in  the  early  stages. 
The  danger  of  infection  in  scarlet  fever  is 
greatest  when  the  skin  commences  to  peel  off, 
which  is  usually  about  the  end  of  the  eighth 
day.  To  prevent  the  skin  flying  about  the 


CONTAGION  85 

room,  and  to  allay  the  intense  irritation,  rub 
your  patient  all  over  with  carbolized  vase- 
line, or  some  other  antiseptic  liniment  twice 
a  day.  In  one  of  the  most  successful  cases 
of  scarlet  fever  that  came  under  my  care,  the 
doctor  ordered  a  bath  twice  a  day  of  warm 
water  and  soap,  with  a  little  bichloride  solu- 
tion added  to  it.  After  the  bath  a  good  rub 
with  alcohol,  and  to  finish  an  application  of  an 
antiseptic  liniment.  The  consequence  was  that 
when  the  skin  peeled,  it  was  rendered  practi- 
cally harmless,  as  it  had  been  thoroughly  disin- 
fected each  day  on  the  body. 

In  cases  of  pulmonary  tuberculosis,  or,  as  it 
is  generally  called,  consumption,  the  infection 
is  carried  in  the  sputum,  which  is  full  of  tuber- 
cular bacilli.  As  long  as  the  sputum  remains 
moist,  the  germs  are  not  able  to  do  much  harm; 
but  when  it  is  allowed  to  dry  on  the  handker- 
chief, and  is  then  exposed  to  the  air,  the  germs 
fly  round  and  are  inhaled  by  thousands  of 
people,  and  in  cases  of  weak  lungs  soon  find 
a  fruitful  soil  to  grow  in.  It  would  be  safer 
to  use  gauze  or  old  linen  that  could  be  immedi- 
ately burned  after  using,  instead  of  handker- 
chiefs, but  people  as  a  rule  are  not  willing  to 
do  this,  and  when  handkerchiefs  are  used  they 


86  HOME   NURSING 

should  be  rolled  up  tightly  and  put  in  a  disin- 
fectant solution  until  they  are  well  boiled.  It 
is  hard  to  make  every  one  realize  how  much 
this  dread  disease  is  spread  for  want  of  proper 
attention  to  this  common-sense  rule.  Any  one 
even  suspected  of  having  consumption  should 
take  strict  precautions  as  to  their  personal 
cleanliness,  and  especially  be  careful  about 
rinsing  out  the  mouth  frequently  with  an  anti- 
septic mouth  wash.  They  should  also  refrain 
from  kissing  other  people,  particularly  children, 
as  that  is  one  of  the  surest  ways  of  spreading 
the  disease.  If  a  member  of  the  family  devel- 
ops consumption,  he  should  always  sleep  alone, 
as  it  has  been  proven  that  in  some  instances 
the  germs  of  the  disease  have  been  commu- 
nicated to  a  member  of  the  family  who  was 
accustomed  to  sleep  with  the  patient. 

Precautions  to  be 
taken  by  the  nurse 

If  for  any  reason  it  is  impossible  to  have  a 
trained  nurse  to  care  for  a  fever  patient,  one 
member  of  the  family  should  undertake  the 
task  of  nursing.  For  the  time  being  she  must 
put  everything  else  aside,  especially  in  the  way 
of  social  pleasures.  She  ought  to  feel  herself 


PRECAUTIONS  TAKEN  BY  THE  NURSE       87 

personally  responsible  for  the  care  of  the 
patient  and  the  sick-room,  and  when  relieved 
from  duty,  by  the  necessities  of  daily  exercise, 
meals,  and  sleep,  she  should  give  careful  direc- 
tions to  whoever  takes  her  place. 

A  plain  cotton  dress  must  always  be  worn 
when  nursing  an  infectious  fever,  so  that  it 
can  be  boiled  and  disinfected  constantly ;  and 
the  nurse's  head  must  be  covered  with  some 
kind  of  a  cap  or  kerchief,  to  prevent  germs 
settling  in  her  hair.  It  is  unwise  to  have 
too  much  starch  in  dress  or  petticoat,  as  the 
rustling  caused  by  it  is  very  irritating  to  a 
nervous  patient,  and  perfumes  or  scented  soaps 
should  be  avoided. 

When  nursing  a  fever  case,  if  you  take  a 
good  walk  in  the  open  air  every  day,  regular 
meals  outside  the  sick-room,  at  least  six  hours' 
sleep  in  the  twenty-four,  a  thorough  warm  bath 
daily,  besides  obeying  the  common-sense  rule, 
—  never  to  enter  the  sick-room  when  tired 
without  eating  or  drinking  something  to  re- 
fresh the  system,  —  there  is  very  little  danger 
of  your  contracting  the  disease.  In  stooping 
over  your  patient,  be  careful  not  to  inhale  his 
breath.  When  nursing  cases  of  diphtheria,  I 
have  found  it  an  excellent  rule  to  cover  the 


88  HOME  NURSING 

mouth  and  nose  with  a  handkerchief  wet  in  a 
solution  of  -^Q-fr  bichloride,  while  spraying  the 
patient's  nose  and  throat;  so  that,  should  he 
cough  suddenly,  you  would  be  protected  from 
the  germs  that  fly  out  of  his  mouth.  I  fol- 
lowed out  this  rule  when  caring  for  four  severe 
cases  of  diphtheria  in  the  mountains  one  sum- 
mer, keeping  the  handkerchief  on  as  I  went 
from  bed  to  bed,  every  hour,  spraying  the 
throats  and  noses,  and  washing  out  the  mouths 
of  the  patients,  and  I  feel  sure  it  was  largely 
owing  to  this  precaution  that  I  escaped  the 
disease. 

One  of  the  most  important  rules  that  the 
home  nurse  needs  to  remember  is  —  never  eat 
anything  in  the  sick-room,  as  the  air  will  be 
full  of  fever  germs  which  are  very  fond  of 
hiding  themselves  in  food.  Before  going  to 
her  meals  she  should  always  rinse  her  mouth 
with  an  antiseptic  mouth  wash,  such  as  lis- 
terine,  or  a  solution  of  boric  acid,  to  remove 
the  germs  that  collect  in  the  mouth,  around 
the  gums,  and  under  the  tongue,  and  to  pre- 
vent their  being  washed  down  the  throat  and 
absorbed  into  the  system. 

A  physician,  in  speaking  on  this  subject,  at- 
tached the  greatest  importance  to  this  precau- 


^DUTIES  OF  THE  NURSE  89 

tion,  so  much  so  that  he  said  he  believed  that 
in  a  few  years  people  would  not  eat  at  any 
time  without  first  rinsing  out  the  mouth  with 
an  antiseptic  mouth  wash.  Microbes  of  all 
kinds  are  continually  flying  round  us,  enter- 
ing our  mouths  every  time  we  open  them  to 
breathe  or  speak,  and  lodging  there  waiting 
to  be  absorbed  into  the  system  with  the  food 
we  eat,  where  they  often  develop  and  cause 
disease. 

The  nurse's  hands  must  also  be  dipped  in  a 
disinfecting  solution  each  time  after  she  has 
been  caring  for  the  patient,  and  the  nails  ought 
to  be  kept  very  short  and  scrubbed  with  a  nail- 
brush, as  they  form  a  hiding  place  for  germs. 
A  solution  of  y0W  bichloride  is  best  for  the 
hands,  and  should  always  be  ready  for  the  use 
of  doctor  and  nurse. 


Duties  of 
the  nurse 


Perhaps  it  might  be  well  if  I  give  here  a 
little  plan  of  the  duties  to  be  accomplished 
during  the  early  morning  hours  to  put  the 
sick-room  in  order  for  the  day. 

As  soon  as  the  patient  wakes,  temperature, 
pulse,  and  respiration  must  be  taken  and  re- 


90  HOME  NURSING 

corded.  Then  there  is,  as  a  rule,  only  time 
enough  to  bathe  the  face  and  hands,  clean  the 
teeth,  and  rinse  the  mouth  before  breakfast. 
Should  the  patient  be  on  fluid  diet,  and  thus 
not  eating  solids,  it  is  unnecessary  to  wait  very 
long  after  breakfast  before  giving  the  daily  bath 
which  is  of  such  especial  importance  in  fever 
cases.  After  the  bath  an  alcohol  rub  is  most 
refreshing  if  the  fever  is  very  high,  or  in  the 
hot  summer  weather.  When  your  patient  is 
too  weak  for  a  daily  bath,  wash  the  hands,  face, 
and  back,  and  rub  the  back  and  limbs  with 
alcohol.  If  the  eyes  should  be  weak  and  the 
lids  red,  wash  them  with  a  solution  of  boracic 
acid,  one  teaspoonful  of  the  boracic  to  a  pint 
of  boiled  water.  Brush  the  hair,  and  when 
long  braid  it  neatly  ;  to  prevent  it  from  fall- 
ing out,  when  it  has  not  been  shaved  off,  clip 
the  ends  regularly  once  a  week  and  rub  bay 
rum  into  the  scalp  daily.  After  the  bath,  slip 
on  a  clean,  well-aired  nightgown  and  fresh 
sheets,  place  a  hot  water  bag  at  the  feet,  and 
give  the  prescribed  nourishment,  and  your  pa- 
tient will  probably  fall  into  a  refreshing  sleep 
while  you  proceed  to  make  the  room  tidy. 


CARE  OF  THE  ROOM  91 

Care  of  the  Room 

The  bed  covering  must  be  as  light  as  pos- 
sible in  fever  cases,  a  sheet  and  one  blanket 
being  sufficient.  Instead  of  a  spread,  use  a 
thin  sheet,  as  it  is  only  needed  to  keep  the 
blanket  clean.  The  oldest  bed  linen  and 
night-clothes  in  the  house  should  be  used,  so 
that  they  will  not  be  hurt  by  frequent  boiling 
and  disinfecting.  Instead  of  handkerchiefs, 
keep  on  hand  a  supply  of  cheese-cloth,  which 
only  costs  five  cents  per  yard,  cut  it  up  into 
small  squares  and  burn  them  as  soon  as  they 
are  used.  This  is  a  very  necessary  precaution 
against  spreading  the  disease,  especially  in  cases 
of  tuberculosis  and  diphtheria.  In  fever  cases 
the  bed  linen  and  night-clothes  ought  to  be 
changed  as  often  as  possible,  as  there  is  always 
a  slight  odor  from  the  fever  unless  everything 
is  kept  immaculately  clean.  As  soon  as  the 
linen  is  taken  off  the  bed,  roll  it  carefully  so 
that  the  germs  cannot  fly  about  the  room,  and 
soak  it  for  at  least  two  hours  in  a  pail  contain- 
ing a  solution  of  fa  carbolic,  after  which  it 
may  be  taken  downstairs  and  boiled  in  soap  and 
water.  Carbolic  is  better  than  bichloride  for 
disinfecting  clothing,  as  the  latter  is  likely  to 
turn  the  clothes  yellow. 


92  HOME  NURSING 

Each  morning  the  floor  needs  to  be  wiped 
with  a  cloth  wet  in  -fa  carbolic  acid  and  fas- 
tened on  the  top  of  the  broom.  The  new  dis- 
infectant "  formalin "  may  prove  to  be  better, 
as  it  is  perfectly  odorless.  A  solution  of  one 
per  cent  is  generally  used  either  in  a  spray  or 
sprinkling  it  over  walls  and  floors.  The  bi- 
chloride, or  corrosive  sublimate  as  it  is  some- 
times called,  is  made  from  the  tablets  that 
come  in  small  blue  bottles.  One  tablet  added 
to  a  pint  of  water  makes  a  solution  of  Y^Vfr- 
This  may  be  increased  or  weakened  as  desired. 
It  is  important  to  remember  that  this  as  well 
as  carbolic  is  a  deadly  poison  and  must  be  kept 
well  out  of  the  reach  of  children.  Six  tea- 
spoonfuls  of  carbolic  to  a  pint  of  water  makes 
a  ^V  solution;  very  hot  water  is  needed  to 
mix  the  oil  in  the  carbolic,  and  it  should  stand 
for  half  an  hour  before  using.  The  cloth 
that  is  used  for  dusting  should  also  be  damp- 
ened with  a  disinfectant,  and  if  you  fill  some 
vessels  with  the  two  per  cent  formalin  solu- 
tion, and  stand  them  in  different  parts  of  the 
room,  it  will  purify  the  air  by  absorbing  some 
of  the  germs  floating  about.  These  solutions 
must  be  renewed  every  twenty-four  hours,  as 
they  lose  their  strength  when  exposed  to  the 
air  for  any  length  of  time. 


CARE   OF  THE   ROOM  93 

An  open-grate  fire  is  particularly  useful  in 
contagious  cases.  Apart  from  its  cheery  as- 
pect, and  help  in  ventilation,  you  can  burn 
small  pieces  of  gauze  or  linen  which  have 
been  used  around  the  patient,  without  remov- 
ing them  from  the  room. 

The  temperature  of  the  room  should  not 
be  higher  than  68°  F.  In  summer  time  the 
air  can  be  kept  cool  by  means  of  an  electric 
fan.  Standing  bowls  of  ice  around  the  room 
will  also  help  to  keep  it  cool.  The  ventila- 
tion must  be  carefully  attended  to  night  and 
day. 

No  food  of  any  kind  should  stand  in  the 
room,  as  it  absorbs  the  microbes  sooner  than 
anything  else.  When  a  bedroom  refrigerator 
is  not  available,  all  eatables  should  be  kept 
in  another  room,  or  outside  the  window.  A 
wooden  box  securely  fastened  with  cords  out- 
side the  window  would  form  a  convenient 
cupboard  for  jellies,  milk,  and  broths,  etc. 

All  glass,  china,  or  silver  in  service  during 
the  illness  ought  to  remain  upstairs,  and  not 
be  returned  to  the  family  dining-room  until 
properly  disinfected. 

Books  and  papers  used  during  a  contagious 
fever  will  have  to  be  destroyed,  as  they  may 


94  HOME  NURSING 

never  be  thoroughly  disinfected.  Should  it  be 
necessary  to  write  letters  from  the  sick-room, 
write  them  with  a  pencil  and  then  dip  the 
paper  and  envelope  in  a  solution  of  yoVfr  bi- 
chloride, allowing  it  to  dry  outside  the  room. 
By  doing  this  you  will  run  little  risk  of  con- 
veying the  disease  to  your  correspondents. 

There  is  generally  a  good  deal  of  headache 
when  the  fever  runs  high,  and  it  is  best  re- 
lieved by  keeping  the  head  cool  with  ice 
cloths.  Keeping  the  feet  warm  will  also  help 
to  cool  the  head,  and  a  brisk  rub  with  alcohol 
for  a  few  moments  will  warm  them  quickly. 

When  the  fever  is  very  intense,  the  feet 
become  dry  and  stiff,  and  much  relief  will  be 
given  by  a  daily  application  of  sweet  oil  and 
menthol  mixed. 

Each  time  before  the  bed-pan  is  used,  put 
a  little  carbolic  solution  in  it,  and  before  emp- 
tying the  contents,  cover  it  completely  with 
carbolic  or  formalin  and  allow  it  to  stand  for 
half  an  hour,  so  that  it  will  be  thoroughly  dis- 
infected. These  precautions  are  especially  to 
be  observed  in  the  case  of  typhoid  fever,  as 
the  germs  of  that  disease  are  found  in  the 
stools  in  great  abundance,  also  in  the  urine 
and  sputum,  and  may  be  easily  communicated 


CAEE  OF  THE  ROOM  95 

to  any  one  nursing  the  case,  unless  particular 
care  is  observed.  It  is  also  necessary  in  typhoid 
fever,  if  there  are  involuntary  movements,  to 
steep  the  bed  linen  immediately  in  a  strong 
solution  of  carbolic  for  a  couple  of  hours. 

Except  when  quite  unavoidable,  no  member 
of  the  family  should  use  the  closet  where  the 
evacuations  of  a  typhoid  fever  patient  are 
emptied  daily.  If  absolutely  necessary  to  do 
so,  plenty  of  disinfectants  should  be  used  all 
the  time.  Formalin  is  one  of  the  best  for 
this  purpose,  and  the  closet  should  be  flushed 
with  boiling  water  two  or  three  times  a  day. 

A  daily  record  must  be  kept  for  the  doctor, 
noting  any  little  change  during  his  absence 
that  may  be  of  assistance  to  him  in  his  treat- 
ment of  the  case.  The  urine  ought  to  be 
measured  and  recorded,  especially  during  scar- 
let fever,  as  Bright's  disease  is  one  of  the  com- 
plications that  sometimes  follows  this  fever, 
and  is  first  shown  by  the  urine  ;  so  that  any 
particular  change  in  the  amount,  color,  or  odour 
of  the  urine  ought  to  be  reported. 

When  there  are  any  signs  of  delirium,  which 
often  accompanies  high  fever,  it  is  very  nec- 
essary that  the  patient  should  not  be  left 
alone  for  a  moment,  for  fear  of  his  injuring 


96  HOME  NURSING 

himself  in  some  way.  If  the  nurse  is  obliged 
to  leave  the  room,  even  for  a  few  moments, 
she  should  take  the  precaution  to  have  some 
one  else  remain  with  the  patient. 

In  preparing  for  the  night,  rub  the  back  and 
limbs  with  alcohol,  and  bathe  the  face  and 
hands.  The  rubbing  will  soothe  the  restless 
feeling  that  comes  after  lying  in  bed  many 
days,  and  it  is  also  a  great  inducement  to 
sleep.  Always  rub  from  the  feet  upward,  in 
long  quiet  strokes.  A  little  cold  cream  or 
glycerine  and  rose-water  on  the  lips  will  pre- 
vent their  chapping  with  the  fever. 

Absolute  rest  of  mind  and  body  are  neces- 
sary to  insure  a  quick  recovery.  A  dim  light 
should  be  kept  burning  all  night,  either  in  the 
room,  well  shaded  from  the  patient's  eyes,  or 
outside  the  door,  because  while  in  a  feverish 
condition  the  patient  may  have  bad  dreams,  and 
wake  up  in  the  dark  frightened  and  nervous. 

When  the  fever  breaks  profuse  perspiration 
is  the  result,  and  there  is  serious  danger  of 
contracting  a  cold.  Rub  the  body  with  a 
warm,  dry  towel,  put  on  a  fresh,  well-heated 
nightgown,  and,  if  necessary,  dry  sheets.  Dur- 
ing some  fever  cases,  I  have  had  to  change  my 
patient  two  or  three  times  in  the  night  to  pre- 


NOURISHMENT  97 

vent  a  chill  from  the  clothes  wet  through  with 
perspiration. 

Nourishment 

In  all  fever  cases  the  diet  for  the  first  stages 
of  the  disease  is  given  in  liquid  form.  This 
generally  consists  of  milk  and  broths.  When 
there  is  any  nausea,  peptonized  milk,  or  milk 
and  lime-water  are  preferred.  About  two  or 
three  ounces,  at  least,  ought  to  be  given  every 
two  hours  while  the  fever  is  at  its  height,  in- 
creasing the  amount  gradually  when  the  tem- 
perature lowers. 

Never  give  stimulants  without  the  doctor's 
orders,  unless  in  a  case  of  collapse  ;  but  it 
would  be  well  to  provide  for  this  beforehand 
by  asking  the  physician  exactly  what  you 
ought  to  do  if  such  an  emergency  should  arise 
during  his  absence. 

All  through  the  day  give  your  patient  plenty 
of  water  to  drink,  for  which  he  will  be  most 
grateful.  Do  not  wait  for  him  to  ask  you,  but 
give  him  a  drink  about  every  two  hours,  as  it 
is  a  great  help  in  reducing  the  fever.  This 
drinking  water  must  be  boiled  and  then  al- 
lowed to  grow  cold  in  the  refrigerator,  as  it 
is  much  safer  than  using  the  ordinary  ice-water. 


98  HOME  NURSING 

In  these  days  the  physicians  agree  that  a  fever 
patient  shall  have  all  the  water  he  desires,  pro- 
vided it  be  boiled.  After  each  feeding,  wash 
out  the  mouth  with  an  antiseptic  mouth  wash. 

In  typhoid  fever  the  tongue  and  gums  be- 
come thickly  coated  with  a  dark  brown  coating, 
called  "  sordes,"  which  if  allowed  to  dry  and 
crack  will  make  the  mouth  excessively  sore ; 
this  can  only  be  prevented  by  frequent  wash- 
ing with  an  antiseptic  solution  and  a  small 
piece  of  gauze  or  cotton  wool,  which  should  be 
burned  immediately. 

It  is  generally  advisable  to  give  some 
nourishment  during  the  night,  and  in  most 
fever  cases  it  is  an  absolute  necessity,  as  a 
high  temperature  is  a  great  strain  on  the  sys- 
tem. But  you  must  be  guided  by  the  physician 
as  to  whether  it  is  necessary  for  you  to  arouse 
your  patient  at  regular  intervals ;  it  will  depend 
entirely  on  his  condition. 

Air 

The  sick-room  in  fever  cases  should  be  as 
large  and  airy  as  possible,  and  during  warm 
weather,  or  if  the  room  is  a  small  one,  it  is  ad- 
visable to  remove  all  the  furniture  except  the 
bed,  a  small  table,  and  a  couple  of  chairs,  so 
that  the  air  will  be  able  to  circulate  freely. 


DISINFECTION  99 

When  there  is  a  great  deal  of  delirium,  a 
mustard  plaster  or  blister  applied  to  the  back 
of  the  neck  will  soothe  the  patient. 

In  diphtheria  the  heart  is  often  affected,  so 
that  it  is  not  wise  for  the  patient  to  make  any 
sudden,  quick  movement  out  of  bed.  He 
should  keep  a  recumbent  position,  and  the 
pulse  be  watched  most  carefully. 

Fresh  air  is  of  the  greatest  importance  in  the 
treatment  of  consumption ;  it  is  almost  the  only 
remedy  that  has  proved  of  any  avail  in  check- 
ing this  dread  disease.  It  has  recently  been 
demonstrated  that  climate  itself  is  not  of  so 
much  importance  as  plenty  of  fresh  air,  and 
that,  so  long  as  an  outdoor  life  can  be  carried  on 
entirely,  consumption  can  be  treated  in  almost 
any  country. 

Disinfection 

As  soon  as  you  have  received  permission  from 
the  doctor  to  move  the  patient  into  another 
room,  give  him  a  good,  hot  bath,  and  then 
sponge  him  all  over,  including  the  hair,  with  a 
weak  solution  of  bichloride,  wrap  him  in  blan- 
kets, and  take  him  into  an  adjoining  room  that 
has  previously  been  prepared  and  made  comfort- 
able. It  is  of  great  importance  that  after  an 


100  HOME  NURSING 

infectious  disease  the  sick-room  should  be  thor- 
oughly and  carefully  disinfected,  as  the  trouble- 
some little  fever  germs  have  a  disagreeable  way 
of  lingering  round  for  months  and  even  years 
in  various  nooks  and  crannies. 

I  have  heard  of  a  case  where  scarlet  fever 
was  contracted  by  a  little  boy  whose  family  had 
moved  into  a  house  where  the  disease  had  been 
nearly  a  year  before.  The  rooms  had  been  dis- 
infected, but  a  toy  closet  off  the  nursery  had 
not  been  properly  cleaned  out.  The  little  boy 
after  playing  there  for  a  few  days  was  stricken 
with  scarlet  fever. 

As  soon  as  you  have  moved  your  patient  out 
of  the  sick-room,  take  all  the  bedclothes  and 
put  them  into  a  pail  of  ^  carbolic  and  let  them 
steep  for  some  hours.  Wrap  up  the  mattress 
and  send  it  to  one  of  the  special  establishments 
for  sterilizing  and  disinfecting  bedding,  to  be 
found  in  almost  every  city.  Should  there  be 
no  such  place  at  hand,  do  not  hesitate  to  burn 
up  the  mattress  as  it  is  impossible  to  disinfect 
it  thoroughly  at  home. 

A  few  years  ago  sulphur  was  deemed  most 
essential  in  fumigating  fever  rooms,  but  it  has 
been  proven  to  be  of  little  value  in  destroying 
the  germs  completely,  though  still  used  in  con- 


DISINFECTION  101 

nection  with  bichloride.  I  have  found  it  as  a 
rule  best  to  use  both  methods. 

First,  fumigating  with  the  sulphur  by  put- 
ting a  good  quantity  of  lump  sulphur  (the  can- 
dles are  not  so  good  as  the  ordinary  lump 
sulphur)  on  a  tin,  place  the  tin  in  a  larger 
one  half  filled  with  water,  and,  after  tightly 
closing  up  doors  and  windows,  set  fire  to 
the  sulphur  and  let  it  burn  for  six  or  eight 
hours. 

At  the  same  time  that  the  sulphur  is  burn- 
ing have  two  kettles  of  water  boiling  in  the 
room  on  a  coal-oil  stove  to  make  the  atmos- 
phere moist.  When  the  sulphur  has  burned 
itself  out,  open  wide  the  windows  for  an 
hour  or  two  to  allow  the  dust  to  settle,  and 
the  air  to  clear  before  commencing  the  second 
stage. 

Then  take  a  pail  of  -^fa  bichloride,  and  wash 
over  everything  in  the  room  from  the  ceiling 
to  the  floor  inclusive,  with  a  plentiful  supply  of 
the  solution.  The  walls  and  ceiling  can  be 
washed  with  a  cloth  tied  over  the  broom,  and 
all  the  furniture  must  be  carefully  gone  over. 
The  bedstead,  if  an  iron  one,  should  be  washed 
with  strong  carbolic  as  the  bichloride  would 
rust  it. 


102  HOME  NURSING 

When  the  fever  has  been  very  severe  and 
infectious,  as  in  scarlet  fever  or  smallpox,  the 
room  ought  to  be  repapered  and  repainted  be- 
fore it  is  used  again. 

The  latest  method  for  disinfecting  and  ster- 
ilizing a  room  after  an  infectious  disease,  is  the 
employment  of  Schering's  formalin  lamps  and 
pastils  to  produce  the  pure  formaldehyde  gas. 
It  is  claimed  to  be  a  perfect  disinfectant  and 
purifier,  and  is  now  used  extensively  instead  of 
sulphur  or  bichloride.  These  formalin  lamps 
may  be  procured  at  any  large  druggist's,  with 
full  directions  as  to  their  use. 

Complication  s 

There  are  a  great  many  complications  to  be 
guarded  against  after  a  case  of  fever,  even  a 
slight  one  ;  and  when  the  temperature  has 
been  very  high  for  any  length  of  time,  the 
whole  body  is  consequently  left  in  a  very 
weakened  condition,  and  is  liable  to  develop 
any  latent  weakness  or  hereditary  disease  at 
the  slightest  exposure.  So  that  the  utmost 
care  should  be  taken  during  convalescence  to 
guard  against  over-fatigue  or  exposure  to  cold. 
It  is  also  well  to  keep  on  taking  the  tempera- 
ture night  and  morning  for  some  days  after  it 


COMPLICATIONS  103 

is  normal,  especially  in  the  case  of  typhoid 
fever,  as  a  rise  in  temperature  during  convales- 
cence may  indicate  some  trouble  that,  if  not 
attended  to,  might  cause  a  relapse  of  the 
fever. 


CHAPTER  VI 

Observation 
of  symptoms 

At  all  times  children  require  a  great  deal  of 
patient  care  and  watchfulness.  But  especially 
when  they  are  ill,  it  is  necessary  to  combine 
with  patience  both  tact  and  sympathy. 

Children  under  four  or  five  years  of  age  are 
quite  unable  to  describe  their  symptoms,  and, 
indeed,  older  children  very  often  cannot  explain 
exactly  where  the  trouble  lies,  or  how  it  af- 
fects them.  It  is  especially  requisite  therefore, 
with  children,  though  also  of  great  importance 
with  older  people,  that  we  cultivate  the  habit 
of  observation  ;  and  the  eye  can  very  soon  be 
trained  to  notice  signs  of  illness,  especially  in 
those  we  love.  "  Soft  infancy  that  nothing 
canst  but  cry,"  is  very  clearly  illustrated  when 
a  child  is  sick,  but  even  the  manner  in  which 
a  child  cries  is  quite  suggestive  as  to  where 
the  pain  lies. 

Crying  immediately  after  coughing  shows 
that  the  cough  has  caused  pain  in  the  chest. 

Incessant  crying  in  a  very  young  child  is  a 
104 


OBSERVATION  OF  SYMPTOMS  105 

sure  indication  of  pain  or  hunger.  If  pain,  the 
trouble  will  frequently  be  found  in  the  ear, 
though  the  child  may  not  be  able  to  locate  it. 

When  there  is  pain  in  the  abdomen  the  cry 
will  be  very  loud,  and  the  child  will  draw  his 
little  legs  up  against  the  abdomen. 

Sharp  screams  at  intervals,  followed  by  low 
moans,  are  a  sign  of  brain  disease. 

A  great  deal  can  also  be  observed  by  watch- 
ing the  child  sleep.  The  position  he  takes  in 
bed  is  very  suggestive,  as  he  will  unconsciously 
assume  the  position  that  gives  him  the  greatest 
relief  from  pain.  In  lung  troubles,  the  child 
will  lie  on  the  side  affected,  so  that  the  air  will 
have  a  better  opportunity  to  enter  the  well 
lung,  and  thus  enable  him  to  breathe  more 
comfortably. 

Knees  drawn  up  against  the  abdomen  during 
sleep,  and  a  twitching  of  the  upper  lip,  often 
indicate  peritonitis. 

When  suffering  from  colic,  a  child  will  turn 
over  and  lie  on  his  stomach.  Frowning  and  a 
continuous  contraction  of  the  eyebrows  accom- 
pany pain  in  the  head.  Restlessness  and  twist- 
ing of  the  eyelids,  while  the  thumb  is  flexed  in 
the  palm  of  the  hand,  is  a  beginning  of  convul- 
sions. 


106  HOME   NURSING 

Should  a  child  complain  frequently  of  head- 
ache, after  he  is  old  enough  to  commence  study- 
ing, while  his  general  health  seems  to  be  all 
right,  you  will  often  find  that  there  is  some 
affection  of  the  eyes,  even  though  the  sight 
may  not  appear  to  be  troubled.  Dark  rings 
under  the  eyes  come  sometimes  from  imperfect 
circulation. 

If  a  very  young  child  keeps  putting  his  hand 
to  ear,  head,  or  throat,  it  often  means  inflam- 
mation or  irritation  of  some  kind  in  that 
locality.  Many  of  these  symptoms  apply  to 
grown-up  people  as  well  as  children,  but  as  a 
rule  they  can  explain  to  you  where  the  trouble 
lies  and  can  describe  the  symptoms,  while  a 
child  has  to  be  treated  almost  altogether  from 
observation,  and  it  is  of  inestimable  value  to 
the  physician,  in  making  his  diagnosis,  if  the 
mother,  sister,  or  aunt,  as  the  case  may  be,  will 
note  any  little  change  or  new  symptom  that 
appears  during  his  absence. 

Children  are  so  often  frightened  or  nervous 
while  a  doctor  is  making  his  visit  that  they 
seldom  appear  as  natural  as  when  alone  with 
familiar  faces. 

Should  the  stomach  or  liver  be  out  of  order, 
you  may  tell  it  at  once  by  looking  at  the 


OBSEEVATION  OF  SYMPTOMS  107 

tongue,  as  it  will  appear  to  have  a  yellow- 
ish white  coating  at  the  back  and  down  the 
middle. 

A  slight  sore  throat  often  comes  from  indi- 
gestion, and  will  soon  disappear  after  a  good 
dose  of  medicine. 

It  is  a  safe  rule  to  follow,  that,  as  soon  as  a 
child  shows  any  symptoms  of  illness,  such  as 
sick  stomach,  diarrhoea,  cough,  accompanied  by 
listlessness  or  irritability  of  temper,  to  put  him 
in  a  good  hot  bath,  and  then  to  bed  for  a  few 
hours,  giving  him  a  dose  of  castor  oil  or  calo- 
mel. By  doing  this  you  will  often  be  enabled 
to  ward  off  an  attack  of  biliousness,  croup,  or 
other  ailment.  If  there  is  any  concealed  rash, 
the  hot  bath  will  help  to  bring  it  out  and  will 
reduce  the  feverish  symptoms. 

A  child's  temperature  goes  up  to  102°  to 
103°  F.  with  very  little  provocation.  Some- 
times constipation  or  indigestion  will  send  it 
up  rapidly  in  a  few  hours. 

To  keep  a  child  in  good  health,  very  regular 
habits  should  be  formed,  as  regards  his  sleep, 
food,  daily  bath,  regulation  of  the  bowels,  and 
outdoor  exercise. 

It  is  a  mistake  to  suppose  that  children  will 
become  hardened  by  exposure  to  cold ;  on  the 


108  HOME  NURSING 

contrary,  a  great  deal  of  sickness  will  be  pre- 
vented by  dressing  them  with  a  flannel  gar- 
ment next  the  skin,  both  winter  and  summer. 

Many  of  the  ills  of  childhood  arise  from  im- 
proper food,  causing  various  intestinal  disturb- 
ances. Gastro-intestinal  irritation  frequently 
leads  to  convulsions  in  young  children. 

When  any  particular  form  of  food  disagrees 
with  a  baby,  he  will  lose  weight,  become  rest- 
less, and  often  cry  incessantly  from  pure 
hunger. 

Constipation 

If  children  are  troubled  with  constipation, 
every  effort  should  be  made  to  overcome  it 
by  establishing  regular  habits.  A  very  gentle 
massage  over  the  left  side  of  the  abdomen,  with 
a  little  vaseline  on  the  hand,  for  eight  or  ten 
minutes  twice  a  day  after  meals;  or  a  small 
suppository  made  of  Castile  soap  slipped  into 
the  rectum  right  after  breakfast,  will  be  of 
great  service  in  overcoming  this  difficulty. 
Outdoor  exercise,  oatmeal  porridge,  plenty  of 
cooked  fruit  and  orange  juice,  will  be  found 
of  assistance  in  promoting  a  regular  action  of 
the  bowels  every  day. 

The  daily  bath  is  of  great  importance  to  a 


WIND  COLIC  — CROUP  109 

child,  and  should  be  given  either  before  break- 
fast or  at  bedtime.  As  their  skin  is  very 
sensitive  and  easily  chapped,  it  must  be  dried 
very  thoroughly,  especially  in  all  crevices,  and 
a  simple  baby  powder  used  to  prevent  mois- 
ture. 

A  very  young  child's  mouth  should  be 
washed  out  after  feeding,  with  a  weak  solu- 
tion of  boracic  acid. 

Wind  colic 

Wind  colic  is  one  of  the  baby's  first  troubles. 
To  cure  it,  keep  him  very  warm  near  the  fire, 
lying  on  his  stomach.  Give  him  some  pepper- 
mint and  hot  water,  and  rub  the  abdomen 
gently  in  a  circular  direction. 

Croup 

That  disease  so  much  dreaded  by  mothers 
sometimes  appears  without  any  warning,  and 
almost  invariably  at  night.  The  child  wakes 
with  a  peculiar  hoarse  cough,  which  once  heard 
is  never  forgotten.  The  breathing  is  labored 
and  long  drawn  out,  with  a  little  whistle  in 
every  breath.  In  severe  cases  a  hot  bath 
should  at  once  be  prepared,  or,  if  that  is  im- 


110  HOME  NURSING 

possible,  a  mustard  foot-bath,  to  relieve  the 
spasms  and  promote  a  profuse  perspiration. 
After  the  bath  wrap  the  child  in  a  blanket, 
put  him  to  bed,  wring  a  flannel  cloth  from  very 
hot  water,  and  apply  it  to  the  throat,  changing  it 
every  three  minutes  to  keep  up  a  steady  heat. 
Give  a  teaspoonful  of  syrup  of  ipecac,  repeat- 
ing in  half  an  hour  to  cause  free  vomiting, 
and  a  simple  soap-suds  enema  to  relieve  the 
bowels. 

Should  the  child  be  subject  to  croup,  you 
can  frequently  ward  off  an  attack  by  giving 
a  dose  of  castor  oil  in  the  afternoon,  as  soon 
as  any  symptoms  of  cold  appear  in  the  system. 
Protect  the  child  well  from  draughts  and  cold 
feet,  and  keep  him  on  a  simple  diet  of  milk, 
broths,  and  cereals  for  a  few  days. 

In  the  case  of  membraneous  or  true  croup, 
the  membrane  forms  thickly  across  the  throat 
and  is  exceedingly  dangerous.  The  tempera- 
ture may  go  up  to  104°  F.,  and  great  exhaus- 
tion is  evident.  A  physician  should  be 
summoned  at  once,  for  if  the  child  is  unable 
to  cough  up  the  membrane,  it  must  be  forci- 
bly removed,  and  sometimes  an  operation  for 
intubation,  or  tracheotomy,  will  be  found  nec- 
essary to  save  the  child's  life. 


WHOOPING  COUGH  111 

Steam  is  of  great  service  in  croup,  and  it  can 
be  inhaled  by  the  child  from  the  spout  of  an 
ordinary  kettle  when  no  especial  apparatus  is 
at  hand.  Fill  the  kettle  with  boiling  water, 
cut  a  piece  of  paper  in  the  shape  of  a  cone, 
fastening  the  narrow  end  around  the  spout  of 
the  kettle,  and  let  the  child  draw  in  the  steam 
through  the  wide  end,  making  at  the  same 
time  a  tent  over  his  head  and  shoulders  with 
a  sheet,  so  that  all  the  steam  will  be  directed 
toward  his  mouth.  The  moisture  arising  from 
the  steam  softens  the  membrane  and  prevents 
its  forming  across  the  throat. 

Whooping  cough 

Though  not  dangerous  in  itself,  whooping 
cough  is  a  very  distressing  disease,  and  ex- 
tremely infectious.  The  infection  is  contained 
in  the  sputum  coughed  up  in  large  quantities 
during  the  paroxysms. 

The  disease  generally  commences  with  a 
feverish  cold,  cough,  and  free  expectoration. 
After  a  few  days  the  convulsive  stage  sets  in, 
a  very  intense  irritation  of  the  air  passages  and 
throat,  causing  paroxysms  of  coughing,  fol- 
lowed by  a  long  gasp  or  whoop.  The  cough 
is  generally  more  severe  toward  night,  und  the 


112  HOME  NURSING 

disease,  as  a  rule,  lasts  from  five  to  eight  weeks, 
disappearing  very  gradually. 

Whooping  cough  sometimes  comes  as  a  se- 
quel to  other  diseases,  such  as  measles  and 
scarlet  fever.  Syrup  of  ipecac  and  paregoric 
are  of  great  assistance  in  soothing  the  cough. 
The  room  should  be  kept  at  an  even  tempera- 
ture, and  no  draughts  allowed  to  blow  upon 
the  child.  The  clothing  should  be  warm,  and 
quiet  games  without  excitement  allowed.  Af- 
ter the  first  two  or  three  weeks  outdoor  exer- 
cise of  all  kinds,  and  during  convalescence  a 
change  of  air,  will  be  found  most  beneficial. 
Cod  liver  oil  should  be  given  for  a  month  or 
two  to  build  up  the  system. 

The  diet  throughout  the  course  of  the  dis- 
ease should  be  light  and  nourishing,  and  a 
daily  action  of  the  bowels  is  necessary.  Car- 
bolized  vaseline  warmed  and  inserted  up  the 
nostrils  with  a  small  nasal  syringe  is  of  great 
service  in  keeping  the  air  passages  open,  and 
thus  allowing  the  child  to  breathe  more  freely. 

Children  should  be  taught  at  all  times  to 
breathe  through  the  nose  instead  of  the  mouth 
when  in  the  open  air,  especially  during  the 
winter.  The  habit  serves  to  prevent  sore 
throat. 


MUMPS  — CONVULSIONS  113 

One  of  my  friends  taught  her  little  girl  to 
gargle,  and  made  her  practice  every  morning 
with  cold  water,  so  that  if  at  any  time  she  had 
a  sore  throat  and  was  obliged  to  use  a  gargle, 
there  would  be  no  difficulty  about  it. 

Mumps 

This  disease  is  infectious,  contagious,  and 
very  painful.  It  generally  lasts  from  eight 
to  ten  days.  Bed  is  the  best  place  for  the 
child  —  though  mumps  is  not  exclusively  a 
child's  disease  —  and  the  quieter  you  keep  your 
patient,  the  better.  The  food  must  be  admin- 
istered in  liquid  form,  as  it  is  impossible  to 
chew  with  the  jaws  stiff  and  swollen.  The 
swelling  reaches  its  height  in  three  or  four  days, 
and  then  disappears  gradually.  Heat  should 
be  applied  in  some  form,  either  in  a  liniment 
that  will  prove  a  counter-irritant,  as  chloro- 
form liniment,  or  else  in  the  form  of  moist  heat 
with  stupes  made  of  flannel  or  small  sponges 
wrung  out  of  very  hot  water,  and  covered  with 
a  piece  of  oil  silk  to  retain  the  heat. 

Convulsions 

Convulsions  arise  from  various  causes,  and 
may  be  either  a  symptom  of  a  disease  not  fully 


114  HOME   NURSING 

developed,  a  complication  in  some  severe  ill- 
ness, or  they  may  be  caused  by  indigestion, 
teething,  or  other  diseases.  When  they  occur 
in  adults,  it  is  almost  always  in  connection 
with  some  severe  illness  or  in  poisoning  cases. 
When  convulsions  are  caused  in  children  by 
some  irritation  of  the  stomach  or  bowels  an 
emetic  should  be  given,  followed  by  an  enema. 
Hot  baths  are  also  very  soothing,  but  must  be 
given  very  carefully  and  gently,  and  then  they 
will  generally  put  the  little  sufferer  to  sleep. 
The  water  should  be  deep  enough  in  the  tub  to 
reach  up  to  the  child's  neck.  The  physician 
will  probably  prescribe  some  soothing  medicine, 
and  the  child  must  be  kept  warm  and  quiet. 

When  convulsions  occur  during  teething, 
lancing  the  gums  will  give  instant  relief. 

Delicate  children  are  inclined  to  take  cold  in 
their  bowels  very  easily,  especially  if  the  food 
is  not  assimilated  properly,  and  they  should 
always  wear  a  flannel  band  over  the  abdomen. 

Diarrhoea 

Though  not  a  disease  of  childhood,  diarrhoea 
is  more  serious  in  a  child  than  in  an  adult,  as 
the  child  is  quickly  exhausted  with  the  contin- 
ual drain  on  the  system. 


DIARRHCEA  115 

A  very  slight  cause  will  bring  on  diarrhoea, 
especially  in  delicate  children,  and  during 
the  warm  weather,  and  if  not  checked  it  may 
very  easily  turn  to  dysentery.  The  first  and 
most  important  symptom  of  dysentery  is  the 
appearance  of  blood  and  mucus  in  the  stools, 
with  severe  griping  pains.  A  physician  should 
be  at  once  summoned,  as  prompt  treatment  is 
necessary  to  check  the  disease.  Rapid  change 
of  temperature  or  diet  is  sufficient  to  start 
diarrhoea,  especially  when  there  is  want  of  care 
or  knowledge  in  the  treatment  of  a  child  with 
such  a  tendency. 

Keep  the  child  scrupulously  clean,  especially 
during  the  hot  weather,  give  him  plenty  of 
fresh  air,  and  guard  against  his  taking  cold 
while  bathing,  or  his  lying  without  covering  at 
night.  This  care,  in  addition  to  the  boiling  all 
the  water  he  drinks,  will  be  of  great  assistance 
in  preventing  an  attack.  As  soon  as  the  diar- 
rhoea appears,  a  dose  of  castor  oil  is  the  best 
remedy  to  remove  any  irritating  substance  that 
may  have  caused  the  trouble.  It  is  wiser  not 
to  check  the  diarrhoea  immediately,  but  if  it 
does  not  stop  after  the  oil  has  acted,  a  little 
bismuth  powder  will  help  to  stop  it.  When 
it  is  possible  to  do  so,  keep  the  patient 


116  HOME   NURSING 

in  bed  until  the  diarrhoea  ceases.  Burnt 
brandy  helps  to  relieve  the  pain  and  is  also 
slightly  constipating.  The  best  diet  is  boiled 
milk  and  arrowroot.  I  have  found  flour  and 
water  whipped  to  a  thick  cream,  a  dessert- 
spoonful taken  every  hour,  most  useful  in 
stopping  the  disease,  and  sometimes  a  starch 
enema  is  necessary,  but  must  never  be  given 
without  the  doctor's  orders.  Hot  stupes  or 
dry  heat  applied  to  the  abdomen  will  be  found 
very  soothing.  In  the  case  of  a  child,  if  the 
temperature  should  rise  very  high,  a  cold  pack 
will  reduce  the  fever  immediately. 

If  the  diarrhoaa  shows  no  sign  of  disappear- 
ing after  a  few  hours,  the  physician  should  be 
summoned. 

Gastric  catarrh 

Very  often  about  holiday  time,  or  after  any 
especial  festival,  it  is  not  unusual  for  a  child  to 
have  an  attack  of  gastric  catarrh  or,  as  it  is  gen- 
erally called,  a  bilious  attack,  caused  by  eating 
too  many  rich  dainties.  If  this  is  not  checked 
at  once,  it  may  develop  into  bilious  fever. 

The  symptoms  are  a  heavily  coated  tongue, 
offensive  breath,  nausea,  sometimes  accompa- 
nied by  vomiting,  languid  feeling,  headache, 


FALL  OR  BLOW  UPON  THE   HEAD       117 

and  fever.  The  temperature  sometimes  rises 
to  103°  F. 

A  good  dose  of  castor  oil  should  be  given 
immediately.  Then  put  the  child  to  bed  and 
sponge  him  off  with  alcohol  and  water. 

Nothing  but  milk,  broths,  and  cereals  should 
be  allowed  for  a  few  days,  and  great  care 
should  be  taken  to  prevent  him  from  contract- 
ing cold. 

Fall  or  blow 
upon  the  head 

Children  frequently  chance  to  receive  a  blow 
on  the  head  by  a  severe  fall  or  other  accident. 
If  the  blow  is  severe  enough  to  cause  uncon- 
sciousness, a  doctor  must  be  sent  for  at  once. 
While  awaiting  his  arrival,  take  the  child  into 
a  quiet  room,  unfasten  the  clothing  around  the 
neck,  apply  ice-cloths  to  the  head,  and  hot 
water  bags  to  the  legs  and  feet ;  but  on  no 
account  give  any  alcoholic  stimulant.  If  the 
stomach  is  not  nauseated,  a  drink  of  hot  milk 
will  be  very  reviving. 

In  some  severe  cases  days  may  elapse  before 
the  child  regains  consciousness,  and  during 
that  period  nourishment  must  be  given  in  the 
form  of  nutritive  enemata. 


118  HOME  NURSING 

St.  Vitus's  dance 

This  trouble  is  confined  almost  altogether  to 
children  with  a  highly  nervous  temperament, 
and  to  overcome  it  a  great  deal  of  patience  and 
careful  watching  are  required.  Plenty  of 
sleep  is  an  absolute  necessity,  and  when  the 
nerves  are  too  excited  to  allow  of  natural  sleep, 
hypnotics  must  be  resorted  to.  A  quiet,  easy 
life  should  be  followed,  with  simple  amuse- 
ments and  plenty  of  outdoor  exercise,  light  but 
bountiful  diet,  without  meat  or  stimulating 
foods,  and  a  free  action  of  the  bowels  daily. 
A  shower  bath  or  brisk  sponge  bath  every 
morning,  commencing  with  lukewarm  water, 
and  gradually  making  it  colder,  and  gymnastic 
exercises  to  strengthen  the  muscles,  are  very 
beneficial. 

A  child  should  always  urinate  at  least  once 
in  every  six  hours,  and  nervous  children  who 
cannot  control  the  urine,  especially  at  night, 
should  not  be  punished,  but  taught  as  far  as 
possible  the  power  of  self-control,  and  be 
treated  by  the  family  physician. 

Loss  of  weight  is  sometimes  one  of  the  first 
signs  of  ill  health  in  children,  and  it  may  be 
well  to  have  them  weighed  often,  especially 
when  they  are  growing  very  rapidly. 


MOVING  SICK   CHILDREN  119 

Do  not  move  a  sick  child  more  than  is  neces- 
sary ;  it  is  a  mistaken  idea  that  it  is  wise  to 
take  them  out  of  bed  and  rock  them  in  your 
arms  when  they  are  suffering  from  pneumonia 
or  other  diseases.  There  is  great  danger  of 
fresh  cold,  and  besides  that,  children  are  so 
easily  excited,  and  their  temperature  goes  up  so 
rapidly  with  the  slightest  cause,  that  the  quieter 
you  can  keep  them  when  sick,  the  better. 


CHAPTER  VII 

Those  of  my  readers  who  have  passed 
through  an  illness  will  readily  understand 
what  a  difference  it  makes  at  meal-time  if 
the  food  is  well  cooked  and  daintily  served, 
inviting  enough  to  create  an  appetite,  even 
where  there  is  little  desire  to  eat. 

One  of  the  first  suggestions  I  should  like  to 
make  is  —  never  ask  your  patient  beforehand 
what  he  or  she  would  fancy  in  the  way  of  food; 
for,  even  in  health,  if  you  are  always  aware 
what  is  to  be  placed  before  you,  the  chances 
are  that  you  will  go  to  the  table  without  the 
ghost  of  an  appetite.  This  is  especially  so 
in  sickness,  and  sometimes  when  there  is  not 
the  slightest  desire  to  eat,  a  little  delicacy 
nicely  cooked,  daintily  served,  and  kept  a  pro- 
found secret  until  uncovered  at  the  bedside  will 
be  received  with  favor  and  enjoyed  thoroughly. 

Preparing  the  food 

The  preparation  of  extra  dishes  ought  not 
to  be  left  in  the  hands  of  an  ordinary  cook, 
unless  you  are  blessed  with  an  exceptionally 

120 


PREPARING  THE  FOOD  121 

good  one.  As  a  rule,  they  are  too  careless  or 
indifferent  to  take  any  extra  trouble  to  have 
everything  piping  hot  and  done  to  a  turn.  It 
does  not  take  more  than  a  few  moments  to 
broil  a  steak,  bird,  or  chop,  and  if  you  super- 
intend the  cooking,  you  will  always  be  sure 
that  it  is  carefully  done.  I  know  of  nothing 
more  annoying  than,  after  ordering  some  es- 
pecial dainty  for  an  invalid,  to  have  it  com- 
pletely spoiled  by  careless  cooking. 

Leave  directions  with  the  cook  to  have 
everything  in  readiness  for  you,  and  then  slip 
down  to  the  kitchen  ten  or  fifteen  minutes 
before  the  meal-time,  and  either  broil  the  meat 
or  bird  yourself  or  superintend  its  cooking. 
Broiling  should  be  done  over  a  very  quick 
fire  to  retain  the  juice  in  the  meat.  Allow  it 
to  be  a  rich  brown  on  the  outside,  and  still 
remain  slightly  red  and  juicy  in  the  middle. 
All  hot  meats  must  be  served  at  once  on  hot 
plates  straight  from  the  fire  to  the  bedside, 
without  being  kept  standing  round  on  the 
stove  or  in  the  oven  getting  hard  and  dry. 
Always  cover  dishes  containing  hot  food  while 
carrying  them  through  passages  and  upstairs. 
Hot  water  plates  arranged  with  a  compart- 
ment under  the  plate  to  be  filled  with  boiling 


122  HOME  NURSING 

water,  thus  keeping  the  food  hot  all  through 
the  meal,  are  very  useful  in  cases  of  long  illness. 

The  tray 

To  make  a  tray  look  attractive  is  almost  as 
important  as  having  the  food  properly  cooked. 
Cover  it  with  a  snowy  napkin  or  tray-cloth 
(if  possible  you  should  use  a  fresh  one  for  every 
meal).  Choose  the  prettiest  and  daintiest 
china  and  glass  in  the  house.  Do  not  cling 
to  the  idea  that  it  is  necessary  to  use  thick, 
cheap  china  in  the  sick-room  for  fear  of  break- 
age, for  this  can  be  avoided  by  careful  han- 
dling, especially  when  washing  the  dishes,  and 
your  invalid  will  appreciate  his  meals  twice  as 
much  when  allowed  the  use  of  the  best  china. 
The  cup  to  be  used  for  tea,  coffee,  or  bouillon, 
is  first  filled  with  very  hot  water  so  that  it 
shall  be  thoroughly  heated.  Tea  or  coffee 
should  be  put  in  a  little  tea-pot  or  covered 
pitcher,  and  not  poured  into  the  cup,  as  it  is  sure 
to  spill  over  into  the  saucer,  and  become  cold 
before  it  reaches  the  bedside.  Besides,  it  is  of 
great  interest  to  some  people  to  pour  out  their 
own  tea  or  coffee,  adding  just  the  amount  of 
sugar  and  cream  they  desire.  Lump  sugar  is 
needed  in  a  dainty  glass  or  silver  bowl,  and 


THE  TRAY  123 

cream  or  hot  milk  in  a  small  pitcher.  A  glass 
of  ice  water  must  never  be  forgotten  on  the 
tray,  as  well  as  pepper  and  salt,  as  tastes  differ 
in  regard  to  seasoning,  and  for  this  reason, 
when  preparing  the  food,  do  not  put  in  all  the 
pepper  and  salt  that  you  think  necessary,  but 
leave  room  for  the  patient  to  add  a  little  or  not 
as  he  desires.  Plates  for  hot  meat  must  be 
very  warm.  Hot  rolls  or  biscuits  are  placed 
between  the  folds  of  a  table  napkin. 

One  of  the  most  important  rules  is  not  to 
crowd  a  tray  with  dishes  and  food,  but  to  give 
very  small  portions  of  everything.  Large,  un- 
tidy pieces  of  meat  swimming  in  greasy  gravy 
will  take  away  any  invalid's  appetite.  Toast 
cut  in  "  ladies'  fingers  "  and  also  baked  potatoes 
look  very  inviting  peeping  from  the  folds  of  a 
snowy  napkin.  Toast  should  be  made  from 
bread  not  fresh,  cut  about  half  an  inch  thick, 
the  crusts  removed,  and  toasted  on  a  fork  or 
broiler  over  a  very  hot  fire,  crisp  and  yet  not 
burned,  soft  and  yet  not  soggy,  and  served  im- 
mediately. Graham  or  wheaten  bread,  rusks, 
or  zwiebach,  make  a  pleasant  change  from  the 
ordinary  white  bread,  and  Huntley  and  Pal- 
mer's breakfast  crackers,  to  be  bought  at  any 
first-class  grocer's,  are  most  appetizing. 


124  HOME  NURSING 

Jellies  look  best  in  glass  dishes,  and  when 
serving  an  egg  fill  the  egg-glass  with  hot  water 
and  roll  the  egg  in  a  doily;  do  not  open  it 
before  reaching  the  bedside. 

A  tiny  sprig  of  parsley  or  water-cress  used 
to  garnish  the  meat  dish,  and  a  fresh-cut  flower 
beside  the  table  napkin,  will  help  to  make  the 
tray  very  attractive. 

Preparing  fruit 

Fruit  should  be  placed  on  ice  for  a  little 
while  before  meals  to  make  it  cold.  Grapes 
need  to  be  washed  and  put  in  a  glass  dish  on 
small  pieces  of  ice.  If  you  wish  to  make  the 
grapes  especially  dainty,  remove  the  skins  and 
the  seeds.  Oranges  are  sliced  with  sugar  after 
being  carefully  peeled,  or  they  are  cut  in  half 
like  grape-fruit,  all  hard  fibres  removed  from 
the  centre,  the  skin  loosened  around  the  edges, 
and  served  with  powdered  sugar.  When  pre- 
paring peaches,  do  not  cut  them  until  just 
before  serving  and  then  use  a  silver  or  plated 
knife.  A  steel  knife  will  leave  a  taste  on  the 
peaches,  and  if  they  are  prepared  even  half  an 
hour  before  the  meal,  they  will  become  dark 
in  color  and  will  not  be  half  so  attractive. 

The  following  is  a  nice  little  dessert  for  a 


SERVING  THE   MEAL  125 

hot  day  in  summer,  and  is  easily  prepared ; 
slice  an  orange,  lemon,  apple,  and  peach,  in  a 
saucer;  add  a  few  cherries  and  a  little  pine- 
apple, and  serve  with  cream  and  sugar ;  or,  if 
you  have  some  wine-jelly  on  hand,  put  it  on 
the  fire  for  a  moment,  then  add  to  it  the  cut- 
up  fruit,  turn  all  together  into  a  jelly-mould, 
and  place  it  on  the  ice  to  cool.  It  will  make 
a  delicious  dessert. 

The  more  attractive  you  can  make  your  tray 
look,  and  the  more  variety  you  arrange  in  the 
way  of  food,  the  greater  will  be  your  patient's 
pleasure  and  enjoyment  in  the  meal ;  and  you 
will  find  it  takes  very  little  more  care  and 
trouble  to  arrange  a  tray  daintily,  than  to  put 
it  before  the  invalid  in  an  untidy  and  slovenly 

manner. 

/ 

Serving  the  meal 

Before  serving  a  meal,  open  the  window  for 
a  moment  to  freshen  the  air.  Wipe  the  pa- 
tient's hands  and  face  with  a  damp  towel,  and 
he  will  be  ready  to  appreciate  his  food.  After 
carrying  the  tray  upstairs,  place  it  on  a  table 
near  the  bed.  If  your  patient  is  allowed  to 
sit  up,  support  his  back  with  a  bed-rest  and 
pillows,  and  throw  a  shawl  over  his  shoulders. 


126  HOME   NURSING 

A  bed-tray  or  bed-table  is  very  useful,  and 
almost  a  necessity  in  long  cases  of  illness,  as 
it  takes  all  the  weight  off  the  patient.  Should 
there  be  none  at  hand,  you  can  improvise  one 
by  placing  two  or  three  books  on  each  side  of 
the  bed  and  laying  a  tray  or  cutting  board 
across  them,  making  the  books  on  each  side 
high  enough  to  prevent  the  tray  resting  on 
the  knees.  Cover  the  tray  or  board  with  a 
table  napkin,  and,  even  if  the  meal  is  a  very 
simple  one,  serve  it  in  courses,  one  dish  at  a 
time.  With  fastidious  people,  it  frequently 
takes  away  any  appetite  they  may  have  if  all 
the  food  is  put  before  them  at  the  same  time. 
In  cutting  up  the  meat  and  opening  the  egg, 
try  and  do  so  in  the  daintiest  manner  possible. 
I  know  of  a  lady  who  dispensed  with  the  ser- 
vices of  her  trained  nurse  because  when  open- 
ing an  egg  for  her  patient  at  the  bedside  she 
put  the  salt  in  with  her  fingers  instead  of  with 
a  spoon  !  The  lady  was  very  particular  about 
her  eating,  and  could  not  take  food  that  was 
not  daintily  served. 

Cut  up  the  bird  or  meat  on  a  side-table, 
open  the  potato  and  season  it,  butter  the  toast, 
and  when  necessary  pour  out  the  tea  and  coffee  ; 
then,  unless  you  have  something  jolly  or  inter- 


SERVING  THE  MEAL  127 

esting  to  talk  about,  take  up  a  book  and  read 
some  bright  little  extract,  or  leave  the  patient 
alone  to  enjoy  his  meal.  Do  not  sit  down  in 
silence  and  watch  every  mouthful  he  takes, 
thus  causing  him  to  hurry  and  taking  away 
the  enjoyment  of  the  meal.  It  frequently  hap- 
pens that  listening  to  some  interesting  story 
will  divert  your  patient's  attention  from  him- 
self, and  he  will  be  likely  to  eat  twice  as  much 
as  if  allowed  to  stop  and  consider  every  mouth- 
ful. Sick  people  have  to  be  humored  a  little 
in  their  fancies,  and  anything  likely  to  give 
them  a  dislike  for  food  is  to  be  carefully 
avoided. 

As  soon  as  the  meal  is  ended,  take  all  the 
empty  dishes  out  of  the  room  immediately, 
remove  the  extra  pillows,  brush  out  any  crumbs 
that  may  have  found  their  way  under  the  bed- 
clothes, and  allow  your  patient  to  lie  down 
quietly  while  you  go  to  your  own  meal,  and 
the  chances  are  that  on  your  return  you  will 
find  him  sleeping  comfortably. 

It  is  a  good  plan  to  serve  the  invalid's  meals 
half  an  hour  before  those  of  the  rest  of  the 
family,  so  that  he  can  be  properly  cared  for, 
and  the  food  will  be  hot  and  comfortable. 
•When  the  appetite  is  very  poor,  give  only  one 


128  HOME  NURSING 

dish  at  each  meal,  instead  of  two  or  three,  and 
solid  food  will  be  more  appreciated,  as  a  rule, 
and  is  more  nourishing  than  sweets  in  any 
form.  A  tiny  quail  or  squab,  daintily  cooked 
and  served  on  a  slice  of  crisp  toast,  a  small 
finger  of  broiled  steak,  a  chop,  a  tiny  piece  of 
the  breast  of  chicken  or  sweetbread  with  cream 
sauce  —  any  of  these  dainties,  prepared  with- 
out the  knowledge  of  the  patient,  will  not  fail  to 
tempt  the  appetite.  Small  pieces  of  crisp  celery, 
served  in  a  glass  dish  on  pieces  of  ice,  are  a 
great  addition  to  a  meal,  and  celery  is  easily 
digested  and  considered  very  soothing  to  the 
nerves.  Or  a  few  tender  leaves  from  the  heart 
of  the  lettuce,  crisp  and  cold,  may  be  served 
with  French  dressing.  When  tomatoes  are 
served,  plunge  them  for  a  second  into  very  hot 
water,  and  the  skin  will  peel  off  easily  ;  then 
lay  them  on  the  ice  for  an  hour  before  the 
meal,  so  that  they  will  be  firm  and  cold  be- 
fore serving.  Cut  them  in  thin  slices  and 
serve  with  any  dressing  required. 

Broths 

Broths  for  sick  people  must  be  entirely  free 
from  the  slightest  appearance  of  grease.  When 
possible,  they  should  be  made  the  day  before 


BEOTHS  129 

they  are  to  be  used,  and  allowed  to  stand  in  a 
cool  place  all  night ;  then  the  grease  will  rise 
to  the  surface  and  can  be  easily  skimmed  off 
before  the  broth  is  heated.  If,  however,  there 
is  the  slightest  appearance  of  grease  after  the 
broth  is  heated,  run  a  crust  of  bread,  or  better 
still  a  piece  of  coarse  blotting  paper,  over  the 
top  two  or  three  times,  and  it  will  disappear. 

To  make  chicken  broth  nicely,  take  an  old 
chicken,  clean  it  thoroughly,  cut  it  in  rather 
small  pieces,  and  put  it  in  a  deep  sauce-pan 
covered  with  water ;  let  it  boil  slowly  for  four 
or  five  hours,  renewing  the  water,  if  necessary. 
Then  strain  and  set  it  aside  over  night ;  it 
ought  to  be  formed  into  a  thick  jelly  in  the 
morning,  and  will  keep  for  days.  A  little  rice 
or  barley,  boiled  very  soft,  added  to  the  chicken 
broth,  makes  a  nice  variety. 

The  best  way  to  cook  beef-tea  is  in  a  bottle. 
Cut  up  a  pound  of  beef  into  small  square 
pieces ;  put  them  in  a  preserve  bottle,  and  add 
two  cups  of  cold  water  ;  stand  the  bottle  on  a 
saucer  in  a  sauce-pan  of  hot  water  and  let  it 
come  almost  to  a  boil.  After  remaining  there 
about  two  hours  it  will  be  ready  for  use,  and 
when  well  seasoned  is  very  good. 

Mutton  broth  ought  to  cook  for  four  or  five 


130  HOME   NURSING 

hours,  and  the  grease  should  be  most  carefully 
removed  before  serving,  as  otherwise  it  is  too 
rich. 

Eggs 

When  poaching  eggs  for  invalids  use  milk 
instead  of  water  to  poach  them  in,  as  it  pre- 
vents their  becoming  watery  and  gives  them  a 
delicate  flavor.  Another  idea  in  poaching  eggs 
is  to  remove  the  pan  from  the  fire  the  moment 
you  have  broken  the  eggs  into  the  water,  and 
thus  allow  them  to  cook  slowly  ;  they  will  be 
much  more  delicate. 

The  nicest  way  to  boil  an  egg,  when  you  have 
plenty  of  time,  is  to  place  it  in  a  bowl,  cover 
with  boiling  water,  and  let  it  stand  for  exactly 
five  minutes  ;  then  pour  off  the  water,  fill  up 
the  bowl  with  fresh  boiling  water,  and  let  it 
stand  for  five  minutes  longer,  and  you  will  find 
the  egg  cooked  to  perfection. 

Scrambled  eggs  should  be  prepared  at  the 
last  moment  before  serving.  When  allowed  to 
stand,  even  for  a  few  moments,  they  become 
hard  and  indigestible.  If  you  beat  up  an  egg 
to  a  froth,  with  the  addition  of  a  little  milk  and 
then  scramble  it  on  a  very  hot  pan,  it  will  be 
very  delicate.  An  omelet  can  be  made  in  a 


SCRAPED  BEEF  131 

few  moments  from  the  following  receipt : 
break  your  eggs,  whites  and  yolks  together, 
into  a  clean  saucer,  add  a  little  salt  and  pepper, 
and  stir  about  fifteen  or  twenty  times  always 
in  one  direction.  Have  your  pan  hot  and  well 
greased,  pour  the  eggs  in  and  let  them  "set" 
before  you  touch  them;  then  slip  your  knife 
under  the  corners  and  under  the  middle  occa- 
sionally to  prevent  its  sticking  to  the  pan. 
While  the  middle  is  still  soft,  double  one- 
half  over  the  other,  and  roll  it  out  on  a  very 
hot  plate,  cover  with  another  plate,  and  serve 
immediately. 

A  chafing-dish  or  alcohol  lamp  is  invaluable 
in  cooking  these  little  dainties,  especially  when 
travelling  or  living  at  a  hotel,  as  you  never  can 
insure  their  being  cooked  properly  in  a  large 
busy  kitchen,  and  after  being  carried  up  three 
or  four  flights  of  stairs  they  will  arrive  cold  and 
unpalatable. 

Scraped  beef 

Scraped  beef  either  made  into  a  sandwich  or 
served  on  toast  is  very  nourishing  and  easily 
digested.  Scrape  the  beef  finely,  and  brown 
for  a  second  on  a  tin  plate  over  the  fire,  sea- 
son nicely,  and  spread  it  between  slices  of  thin 


132  HOME  NURSING 

bread  and  butter,  toasted  crackers,  or  on  toast. 
Or  another  method  is  to  put  the  scraped  beef  be- 
tween two  thin  slices  of  stale  bread,  and  toast 
it  between  a  fine  wire  broiler.  The  heat  makes 
the  bread  nice  and  crisp,  and  sends  the  juice 
of  the  meat  into  it.  Don't  cook  it  too  much. 
A  little  butter  may  be  added  if  desired.  It 
can  also  be  made  into  the  form  of  a  ball,  by  the 
addition  of  the  white  of  an  egg  well  beaten 
to  hold  it  together.  Scraped  beef  is  often  or- 
dered raw,  and  when  scraped  very  finely,  with 
plenty  of  pepper  and  salt,  and  placed  between 
thin  bread  and  butter,  it  is  really  easy  to  take, 
and  is  very  nourishing. 

When  recovering  from  typhoid  fever,  scraped 
beef  is  the  first  solid  food  ordered  for  the 
patient,  as  it  gives  the  greatest  amount  of 
nourishment  in  the  most  easily  digested  form. 
Beef  chopped  by  the  butcher  into  small  pieces, 
and  then  put  into  the  frying-pan  with  a  very 
little  water,  butter,  pepper,  and  salt,  heated 
through  over  a  quick  fire  and  served  on  toast, 
makes  a  nice  variety. 

Beef  juice 

Beef  juice  is  one  of  the  most  useful  forms 
of  nourishment  in  times  of  illness,  when  the 


MILK  PUNCH  183 

stomach  is  delicate,  and  the  patient  weak  and 
without  appetite.  A  thick,  juicy  steak  is 
needed  to  prepare  the  beef  juice.  Cut  the 
meat  into  pieces  about  two  or  three  inches 
square ;  warm  it  for  a  moment  over  the  fire ; 
then  squeeze  into  a  glass  with  the  lemon- 
squeezer.  About  two  ounces  may  be  given  at 
one  time.  When  you  have  squeezed  it,  stand 
the  glass  in  a  cup  of  boiling  water  and  let  it 
heat  slowly.  Watch  it  carefully,  if  allowed  to 
get  too  hot  the  beef  juice  will  coagulate  and 
spoil.  Add  plenty  of  salt  and  pepper,  and,  if 
necessary,  a  little  hot  water.  Sometimes  the 
beef  juice  can  be  taken  better  when  cold;  in 
that  case,  add  some  small  pieces  of  cracked  ice. 
All  children  are  fond  of  beef  juice,  and  will 
often  take  it  when  nothing  else  pleases  them. 

Milk  punch 

Milk  punch  is  very  refreshing  between  meals, 
and  is  made  with  three-quarters  of  a  glass  of 
milk,  half  a  teaspoonful  of  sugar,  and  four  tea- 
spoonfuls  of  whiskey,  also  some  cracked  ice. 
When  there  is  no  milk-shaker  on  hand,  put  all 
the  ingredients  into  a  glass  and  cover  with  an- 
other one  of  the  same  size ;  then  shake  up  and 
down  until  quite  frothy. 


184  HOME  NURSING 

Eggnog 

One  egg,  a  tablespoonful  of  whiskey  or 
sherry,  half  a  glass  of  milk,  and  sugar  to  taste. 
Beat  the  white  and  yolk  separately,  and  keep 
out  a  little  of  the  white  for  the  top.  A  little 
nutmeg  grated  on  the  top  is  an  addition. 

Orange  and  vichy 

A  delicious  drink  can  be  made  from  the 
juice  of  two  oranges  or  a  lemon,  with  half  a 
glass  of  vichy  or  soda  water,  and  some  ice. 
This  is  especially  refreshing  during  the 
summer. 

If  your  patient  awakes  in  the  morning  with 
a  disagreeable  taste  in  his  mouth,  the  juice  of 
an  orange  before  breakfast  is  most  refreshing, 
and  is  also  a  help  in  keeping  the  bowels  in 
order.  The  juice  of  grape-fruit,  with  sugar 
and  ice,  is  also  delicious. 

Wine  whey 

Wine  whey  makes  a  delicate  little  supper 
dish,  with  half  a  cup  of  milk  and  three  ounces 
of  sherry.  Scald  the  milk,  add  the  wine,  take 
right  off  the  fire,  put  on  the  ice  to  get  cold, 
and  sweeten  to  taste. 

One   well-known  physician   always    recom- 


MILK  185 

mends  a  tiny  piece  of  tender  bacon  for  break- 
fast, as  being  very  appetizing  and,  when 
properly  cooked,  quite  digestible.  Cut  the 
bacon  in  very  thin  slices  and  fry  it  over  a  hot 
fire.  Pour  off  the  grease,  allow  boiling  water 
to  run  over  the  bacon  three  separate  times 
while  cooking,  so  that  it  will  be  crisp  and  per- 
fectly free  from  the  slightest  particle  of  grease. 

Meat  or  chicken  jelly,  ice-cold  and  well 
seasoned,  makes  a  nice  variety. 

In  cases  of  kidney  disease  the  diet  should  be 
limited  almost  entirely  to  vegetables,  skimmed 
milk,  and  plenty  of  water. 

Dyspeptic  people  should  avoid  all  starchy 
food,  and  take  only  the  simplest  diet. 

In  gout  and  rheumatism  no  sweets  or  sugar 
should  be  given  ;  white  meat  instead  of  dark 
should  be  eaten,  and  also  gluten  bread  and 
toast. 

The  hard  part  of  an  oyster  should  never  be 
given  to  sick  people,  as  it  is  very  indigestible. 

Milk 

Milk  is  considered  the  most  perfect  food  in 
illness,  as  it  contains  all  the  necessary  ingredi- 
ents to  sustain  life.  It  can  be  given  in  many 
different  forms,  viz.,  diluted  with  lime-water 


136  HOME  NURSING 

or  vichy,  boiled,  sterilized,  or  peptonized,  or 
in  one.  of  the  prepared  forms,  as  matzoon, 
kumyss,  somal,  malted  milk,  or  homely  butter- 
milk. In  Germany  buttermilk  is  used  very 
extensively  ice  cold,  but  never  after  it  is  forty- 
eight  hours  old. 

When  peptonizing  milk,  use  the  little  tubes 
of  peptonizing  powder,  and  follow  the  direc- 
tions carefully.  Do  not  prepare  more  than  a 
pint  at  a  time,  as,  if  allowed  to  stand  any 
length  of  time,  it  becomes  bitter  and  unpleas- 
ant to  the  taste. 

Children  when  ill  sometimes  object  to  tak- 
ing milk.  One  mother  I  heard  of  was  bright 
enough  to  add  a  few  drops  of  vanilla  essence 
and  a  little  sugar  to  the  glass  of  milk,  and 
called  it  "  liquid  ice-cream,"  and  her  little 
boy  drank  it  with  great  delight,  although  he 
would  not  touch  a  glass  of  plain  milk.  Some- 
times the  addition  of  a  little  hot  water  and 
sugar,  and  one  teaspoonful  of  tea,  will  insure 
the  milk  being  received  with  favor  by  the 
little  one  under  the  name  of  "cambric  tea." 
The  white  of  an  egg  well  beaten  and  mixed 
with  an  equal  part  of  water  and  a  few  drops 
of  vanilla  essence  or  lemon  juice  is  very  nour- 
ishing and  stimulating. 


FEEDING  HELPLESS  PATIENTS  187 

Sterilized  milk 

When  there  is  no  regular  sterilizer  on  hand 
in  a  private  house,  and  it  is  necessary  to  sterilize 
the  milk,  put  it  in  small  bottles  which  have 
previously  been  scalded,  and  use  absorbent  cot- 
ton for  corks.  Then  place  the  bottles  in  a 
sauce-pan  half  filled  with  water,  standing  them 
on  a  brick  %  or  a  plate  turned  upside  down  in 
the  bottom  of  the  sauce-pan,  cover  over  tightly, 
and  let  them  steam  slowly  for  two  hours ;  then 
put  the  bottles  in  a  cool  place,  and  do  not 
uncork  them  until  you  are  ready  to  use  the 
milk. 

Feeding  helpless 
patients 

When  feeding  helpless  patients,  it  should  be 
done  with  great  care  and  delicacy.  Do  not 
have  the  glass  or  cup  more  than  half  full,  or 
it  will  surely  spill  down  the  neck.  Raise  the 
head  gently,  but  not  too  much  forward,  or  you 
will  prevent  your  patient  swallowing  easily. 
Do  not  give  the  food  too  fast.  A  small  cup 
with  a  wide  top  will  be  found  the  easiest  kind 
from  which  to  drink  when  the  head  is  low. 

If  your  patient  is  only  allowed  one  or  two 
tablespoonfuls  at  a  time,  do  not  tantalize  him 


138  HOME  NURSING 

by  filling  the  glass  half  full  and  telling  him  to 
take  a  few  sips.  Just  put  in  the  exact  amount 
to  be  given,  and  allow  him  to  drain  every  drop. 
When  children  are  only  allowed  a  certain 
quantity  at  one  time  they  will  be  much  more 
contented  if  you  fill  a  small  glass  full,  instead 
of  giving  them  a  small  quantity  in  a  larger 
glass. 

If  a  feeding-cup  is  used,  a  glass  one  is  the 
best,  as  you  can  see  just  how  quickly  the  fluid  is 
flowing,  and  you  will  not  be  likely  to  choke 
your  patient  by  giving  it  too  rapidly.  But  a 
glass  tube  is  better  than  a  feeding-cup  and  is 
more  easily  managed.  If  it  is  not  bent  at  the 
right  angle,  hold  it  over  the  flame  of  an  alcohol 
lamp  for  a  second,  and  you  can  then  bend  it 
any  shape  you  desire.  With  some  patients  it 
is  better  to  give  them  their  nourishment  at 
short  intervals  and  in  small  quantities  ;  and, 
again,  others  need  to  wait  three  or  four  hours 
between  meals  to  allow  the  stomach  to  empty 
itself  thoroughly  before  being  filled  again.  It 
depends  so  much  upon  the  nature  of  the  dis- 
ease and  the  condition  of  the  patient,  that  no 
regular  law  can  be  laid  down  in  regard  to  how 
often  nourishment  should  be  given.  When 
there  is  a  great  drain  on  the  system  in  the  way 


BILL  OF  FARE   FOR  ONE   DAY  139 

of  a  discharge  from  an  open  wound,  or  a  gen- 
erally run-down  condition,  or  after  a  high  fever 
has  exhausted  the  vitality,  a  great  deal  of  ex- 
tra nourishment  is  necessary  to  keep  up  the 
strength,  and  you  must  induce  your  patient  to 
eat  and  drink  as  much  as  possible.  During 
convalescence  something  like  the  following 
may  be  used :  — 

Bill  of  fare 
for  one  day 

Breakfast,  about  8  A.M.,  consisting  of  a  little 
fruit  (raw  or  cooked)  ;  one  of  the  many  cereals 
nicely  prepared ;  an  egg  in  some  form,  or  a 
small  piece  of  broiled  fish  or  bacon ;  tea  or 
coffee  and  toast.  Hot  cakes  or  biscuits  are 
not  easily  digested  when  one  is  confined  to 
bed. 

About  11  A.M.,  if  tired  after  the  daily  bath, 
a  cup  of  bouillon,  eggnog,  or  milk  punch  will 
be  refreshing. 

At  1  P.M.  the  heartiest  meal  of  the  day 
should  be  taken.  Oysters,  with  the  hard  part 
cut  out,  or  soup,  to  begin  with;  then  some 
meat,  either  rare  broiled  steak,  chop,  quail, 
squab,  chicken,  or  sweetbread,  with  one  vege- 
table —  baked  potato,  string  beans,  spinach,  or 


140  HOME  NURSING 

stewed  celery.  A  simple  dessert,  if  desired,  as 
custard,  milk  pudding,  rennet,  or  ice-cream. 

In  the  middle  of  the  afternoon  a  little  fruit, 
cup  of  cocoa  or  chocolate,  or  thin  bread  and 
butter  and  tea,  is  acceptable  and  helps  to  break 
the  monotony  of  the  day,  and  at  six  o'clock  a 
simple  supper  of  egg  in  some  form,  scraped 
beef  sandwich,  creamed  chicken,  or  a  tiny  bird 
with  milk-toast  and  a  baked  apple  or  preserved 
fruit  should  be  served. 

When  nourishment  is  necessary  during  the 
night  or  in  the  early  morning  hours,  as  it 
often  is  when  recovering  from  a  severe  illness, 
broth,  hot  milk,  bouillon,  or  cocoa  is  best. 
Should  your  patient  be  on  a  milk  diet,  he 
ought  to  take  at  least  four  ounces  of  milk 
every  two  hours,  and,  if  possible,  six  ounces. 

The  juice  of  fresh  fruit  is  at  all  times  better 
than  the  pulp,  and  more  easily  digested. 

In  all  cases  of  illness  food  plays  a  very 
important  part  and  should  be  given  careful 
attention.  It  either  helps  or  hinders  a  rapid 
recovery. 

The  appetite  of  a  sick  person  has  to  be 
coaxed  and  encouraged,  as  a  rule,  and  you  will 
generally  find  that  many  things  they  care  for 
when  in  health  become  very  distasteful  when 


INDIGESTION  141 

confined  to  bed,  so  that  the  more  change  and 
variety  you  can  devise  in  the  bill  of  fare, 
the  more  likely  your  invalid  will  be  to  take 
the  desired  amount  of  nourishment.  Arrange 
every  morning  what  you  decide  to  give  for 
the  next  twenty-four  hours,  and  then  see  that 
all  necessary  supplies  are  on  hand.  If  it  should 
be  the  housekeeper  of  the  family  who  is  ill,  try 
and  make  all  arrangements  without  referring 
to  her,  and  you  will  find  that  she  will  enjoy 
doubly  whatever  you  set  before  her,  particu- 
larly if  you  contrive  some  new  dish  that  she 
has  not  tasted  before. 

Children,  when  sick,  require  the  very  sim- 
plest food.  It  is  difficult  to  get  them  to  take 
more  than  a  few  mouthfuls  when  they  do  not 
feel  hungry,  so  they  ought  to  have  the  most 
nourishing  food  in  small  quantities  about  every 
two  hours,  and  if  you  can  call  it  by  odd  names 
and  turn  the  meal  into  play,  they  will  often 
forget  themselves  and  be  coaxed  into  taking  a 
sufficient  quantity. 

Indigestion 

When  troubled  with  indigestion  eat  your 
food  slowly,  especially  chewing  every  mouthful 
carefully,  and  do  not  eat  between  meals,  but 


142  HOME  NUESING 

allow  the  stomach  time  to  empty  itself  com- 
pletely. Avoid  anything  in  the  way  of  pork, 
fried  meats,  pastry,  or  sweets.  Take  a  glass  of 
cold  water  half  an  hour  before  meals,  but  no 
liquids  with  the  meal,  and  plenty  of  exercise 
in  the  open  air.  Never  eat  when  physically 
tired ;  take  some  stimulating  drink,  such  as 
milk,  cocoa,  eggnog,  etc.,  and  lie  down  for 
half  an  hour  before  eating  anything  solid. 
Nervous  indigestion  requires  an  especial  treat- 
ment of  the  nerves  before  it  can  be  cured. 


CHAPTER  VIII 

Poultices 

Linseed  poultices  are  more  frequently  used 
than  any  other  kind  of  poultices,  and  it  is  very 
necessary  to  know  exactly  how  to  make  them  ; 
they  should  always  be  very  hot,  light,  and 
moist ;  never  try  to  make  them  unless  the 
water  is  really  boiling.  Between  one  and  a 
half  or  two  cups  of  water  is  enough  for  an  ordi- 
nary-sized poultice.  As  soon  as  the  water 
boils,  take  a  large  spoon  in  one  hand,  and  in 
the  other  a  handful  of  meal,  shake  the  meal 
into  the  water,  at  the  same  time  stirring  briskly. 
When  it  is  as  thick  as  a  good  batter  and  evenly 
mixed,  it  is  ready  for  use.  A  little  mustard 
may  be  added,  if  necessary,  or  any  other  medi- 
cation that  has  been  prescribed.  Pour  it 
out  evenly  on  a  piece  of  old  linen  or  mus- 
lin, which  should  be  twice  the  size  needed 
for  the  poultice,  so  as  to  leave  a  large  margin 
to  turn  up  all  around.  After  turning  up  the 
edges,  I  find  it  better  to  put  in  a  few  stitches 
around  the  sides  —  if  you  have  a  needle  and 
143 


144  HOME  NUESING 

thread  ready  it  will  not  take  a  moment  —  then 
you  may  be  absolutely  certain  that  the  poultice 
will  not  fall  to  pieces  and  cause  your  patient 
great  discomfort.  Never  make  a  poultice  too 
thick  ;  it  is  far  better  to  make  it  thin  and 
change  a  little  oftener  than  to  have  a  heavy 
weight  resting  on  a  sensitive  part  of  the  body. 
When  a  poultice  has  to  be  carried  any  dis- 
tance before  being  applied,  up  a  flight  of  stairs 
or  through  a  cold  hall,  cover  it  with  a  piece  of 
flannel  or  put  it  between  two  hot  plates,  as  it 
should  be  applied  as  hot  as  your  patient  can 
endure  it. 

Poultices  need  to  be  changed  about  every 
two  hours,  as  they  cause  more  harm  than 
good  if  allowed  to  get  cold  and  chill  the 
patient.  When  changing  a  poultice  be  careful 
not  to  uncover  your  patient  more  than  is  abso- 
lutely necessary  to  make  the  change  quickly. 
Wipe  the  moisture  from  the  skin  each  time 
before  applying  a  fresh  poultice,  and  if  you 
cover  it  with  a  thin  layer  of  cotton  wool,  and 
place  over  that  a  piece  of  oil  silk,  it  will  retain 
its  heat  for  the  full  two  hours.  When  apply- 
ing a  poultice  to  the  abdomen,  a  bandage  about 
twelve  inches  wide  should  be  firmly  pinned 
round  the  body  to  keep  it  in  place.  When 


MUSTAKD  PASTE  145 

/ 

applied  to  the  back  or  chest,  it  may  be  made 
quite  secure  by  pinning  it  to  the  undershirt  or 
nightgown  with  safety-pins.  There  is  always 
danger  of  the  patient  taking  cold  after  poul- 
tices have  been  applied  for  any  length  of  time, 
as  they  tend  to  make  the  system  very  suscep- 
tible, so  that  when  they  are  no  longer  neces- 
sary, put  an  extra  covering  of  cotton  wool  or 
flannel  for  a  few  days  over  the  spot  where 
the  poultice  has  been. 

Mustard  paste 

Mustard  may  be  applied  either  in  the  form 
of  a  regular  mustard  paste,  or  you  may  buy  a 
package  of  mustard  leaves  at  any  druggist's 
all  ready  for  use,  and  they  are  very  convenient, 
especially  when  travelling,  being  easily  carried 
and  applied  by  moistening  the  leaf  with  warm 
water,  and  placing  a  thin  piece  of  muslin  or 
gauze  between  the  leaf  and  the  skin.  But  an 
old-fashioned  mustard  plaster  is,  as  a  rule,  the 
better.  The  ordinary  mustard  paste  is  made 
by  using  flour  mixed  with  mustard,  making 
the  application  any  strength  required.  For 
children  it  is  wiser  to  use  six  or  eight  tea- 
spoonfuls  of  flour  to  one  of  mustard,  as  their 
skin  is  very  tender  and  sensitive  ;  but  for  an 


146  HOME  NUKSING 

adult  three  or  four  teaspoonfuls  of  flour  to  one 
of  mustard  is  about  the  right  strength.  The 
paste  must  be  made  very  smoothly  and  about 
the  consistency  of  thick  cream.  Use  luke- 
warm water  to  mix  it  with  and  spread  it  on  a 
piece  of  old  linen,  muslin,  or,  if  there  is  noth- 
ing else,  brown  paper.  If  you  lay  the  mustard 
plaster  on  a  very  hot  plate  or  against  a  hot 
water  bag  for  a  few  moments  before  applying 
it,  you  will  prevent  the  disagreeable  sensation 
that  is  caused  when  the  plaster  is  applied  cold. 
Using  white  of  egg  instead  of  water  when 
mixing  the  mustard  removes  some  of  the  dan- 
ger of  blistering,  and  this  danger  may  also  be 
guarded  against  by  rubbing  the  skin  with  vase- 
line before  applying  the  plaster.  A  mustard 
paste  does  its  work  very  quickly  and  should  be 
removed  as  soon  as  the  skin  is  a  bright  red 
color.  Never  allow  your  patient  to  fall  asleep 
with  a  plaster  on,  or  a  blister  will  be  the 
result.  A  little  vaseline  or  sweet  oil  on  a  piece 
of  linen  should  be  applied  after  the  plaster  is 
removed. 


Blisters 


Blisters  are  ordered  when  a  strong  counter- 
irritant  is  needed  to  draw  out  the  inflammation 


OIL-SILK  JACKET  147 

from  some  part  of  the  body.  Before  applying 
a  blister  wash  the  skin  carefully  with  soap 
and  water,  rub  with  alcohol,  and  dry  thor- 
oughly. Apply  the  blister  and  cover  loosely 
with  a  bandage,  leaving  plenty  of  room  for  the 
skin  to  rise  with  the  blister.  After  about  five 
or  six  hours,  remove  the  blister  and  prick  the 
skin  underneath  with  a  needle  or  pair  of  scis- 
sors that  have  previously  been  passed  through 
the  flame  of  a  lamp  or  candle.  Catch  the  fluid 
that  flows  out  with  some  absorbent  cotton,  and 
dress  with  carbolized  vaseline  or  zinc  ointment 
spread  on  a  piece  of  old  linen. 

Oil-silk  jacket 

In  cases  of  pneumonia  an  oil-silk  jacket  is 
often  ordered  by  the  physician.  This  is  made 
with  layers  of  cotton  wool  covered  on  the  in- 
side with  gauze  and  on  the  outside  with  a  piece 
of  oil  silk.  It  should  be  made  large  enough  to 
fold  completely  round  the  chest  and  back.  It 
ties  over  the  shoulders  and  down  one  side  with 
strings  of  tape.  When  it  is  time  to  remove 
the  jacket,  cut  off  an  inch  or  two  from  the  bot- 
tom every  day,  and  thus  it  may  be  removed 
gradually  without  too  much  shock  to  the 
system. 


148  HOME   NURSING 

Hot  stupes 

Moist  heat  is  of  great  service  in  reducing 
inflammation,  and  it  may  be  applied  best  in  the 
form  of  hot  stupes.  These  stupes  are  made 
about  eight  or  ten  inches  square,  from  a  piece 
of  flannel  or  old  blanket.  In  order  to  wring 
them  out  of  the  hot  water  without  burning  the 
hands,  have  a  towel  ready,  folded  lengthwise ; 
catch  the  hot  stupe  by  one  corner,  drop  it  into 
the  towel,  wr.ap  up  tightly,  and  twist  the  ends 
of  the  towel  in  opposite  directions  until 
squeezed  dry.  Then  carry  it  to  the  bedside, 
but  do  not  remove  the  hot  stupe  out  of  the 
towel  until  ready  to  apply,  as  it  cools  very 
rapidly.  Cover  over  with  cotton  wool  and 
oil  silk  to  retain  the  heat.  Flannel  stupes 
must  be  changed  every  ten  or  fifteen  minutes 
to  keep  up  an  even  temperature. 

Turpentine  stupes  are  prepared  the  same 
way  as  the  simple  flannel  ones,  with  the  addi- 
tion of  about  three  teaspoonfuls  of  turpentine 
to  every  two  cups  of  boiling  water. 

Dry  heat 

When  dry  heat  is  required  flannel  may  be 
heated  in  the  oven  or  against  a  hot  brick  or 
iron,  and  applied  as  hot  as  can  be  borne. 


DRY  HEAT  149 

Bags  of  salt  warmed  in  the  oven  are  also  of 
great  use  when  dry  heat  is  required.  The  bags 
should  be  covered  with  flannel. 

Hot  water  bags  are  also  serviceable  in  apply- 
ing dry  heat.  The  bag  should  be  only  half  full, 
and  all  the  air  pressed  out  before  putting  in 
the  stopper;  screw  on  the  top  very  firmly. 
One  cause  for  the  leakage  of  hot  water  bags 
is  that  the  little  rubber  washer  around  the 
stopper  gets  worn  out  and  needs  renewing 
frequently.  Hot  water  bags  may  be  bought 
of  all  sizes,  from  the  tiny  black  rubber  ones, 
three  or  four  inches  long,  which  are  so  useful 
in  faceache  or  earache,  to  the  large  ones  hold- 
ing two  or  three  quarts.  One  or  two  ought 
always  to  be  on  hand,  as  they  may  be  used  for 
hot  or  ice-cold  water.  In  cases  of  severe,  ner- 
vous headache  one  of  these  thin,  black  rubber 
bags,  filled  with  ice-water  and  applied  to  the 
top  of  the  head  or  back  of  the  neck,  will  give 
great  relief,  and  for  a  severe  backache  there 
is  nothing  so  comforting  as  a  good  hot  water 


When  no  hot  water  bags  are  to  be  had  in 
case  of  an  emergency,  bricks  may  be  heated 
and  covered  with  flannel,  and  I  have  some- 
times used  a  smoothing  iron,  well  wrapped  in 


150  HOME  NURSING 

paper  and  flannel,  to  warm  the  feet.  Hot  water 
bottles  are  rather  dangerous,  as  they  sometimes 
break  and  scald  the  patient 

Cold  applications 

In  some  forms  of  acute  inflammation,  cold 
applications  are  indicated  instead  of  hot.  Ice- 
coils  are  often  used  on  the  head  or  abdomen,  but 
they  are  troublesome  to  manage  and,  as  a  rule, 
ice-caps  are  used  instead  outside  the  hospital. 
In  filling  an  ice-cap  the  ice  must  not  be  cut  too 
small,  or  it  will  melt  away  very  quickly,  and 
a  piece  of  linen  or  gauze  must  always  be  placed 
between  the  ice-cap  and  the  skin,  so  that  the 
cold  will  not  be  too  intense.  Never  fill  an  ice- 
bag  too  full,  or  the  weight  of  it  will  do  more 
harm  than  good.  You  must  also  bear  in 
mind  that  they  lose  their  utility  if  allowed  to 
get  warm,  so  they  must  be  changed  as  soon 
as  the  ice  melts.  A  little  sawdust  mixed  with 
the  ice  will  prevent  its  melting  too  quickly. 

Cold  compresses  of  old  linen  gauze  or  muslin 
are  of  infinite  value  in  cases  of  nervous  head- 
ache, sore  throat,  or  intense  fever  or  delirium. 
The  best  way  to  manage  them  is  to  put  a  large 
piece  of  ice  into  a  basin,  pour  a  little  alcohol 
or  bay- rum  over  it,  and  lay  pieces  of  linen  on 


COUNTER-IRRITANTS  151 

the  ice,  when  they  will  become  cold  without 
being  too  wet.  Any  one  subject  to  headaches 
knows  how  uncomfortable  it  is  to  have  a  cold, 
wet  cloth  on  the  head  that  drips  down  at  each 
corner  into  the  ears  and  down  the  back  of  the 
neck.  This  can  be  quite  avoided  by  placing 
the  compresses  on  ice  instead  of  in  water. 

Counter-irritants 

Iodine  is  a  good  counter-irritant,  Churchill's 
iodine  being  the  strongest  kind.  It  is  applied 
with  a  camel's  hair  brush.  When  the  skin  is 
very  sensitive  and  the  iodine  is  likely  to  cause 
a  blister,  it  may  be  removed  with  alcohol. 

Oil  of  wintergreen  is  another  good  counter- 
irritant,  especially  in  cases  of  grippe  when 
there  are  pains  in  the  limbs  and  back  from 
cold.  It  should  be  rubbed  in  rather  lightly 
at  first  and  repeated  in  a  few  hours. 

Equal  parts  of  turpentine  and  vaseline  I 
find  more  useful  than  any  other  liniment,  es- 
pecially when  there  is  a  heavy  cold  on  the 
chest.  Melt  the  vaseline  over  the  fire  or  lamp 
and  mix  in  the  turpentine.  When  applying 
any  of  these  liniments,  protect  the  clothing 
from  coming  in  contact  with  them,  as  the  oil 
contained  in  them  leaves  unsightly  stains. 


152  HOME  NURSING 

Capsicum  vaseline,  which  may  be  bought  in 
tubes,  is  another  good  counter-irritant,  but 
care  must  be  taken  not  to  put  it  near  the  eyes, 
as  it  would  injure  them. 

Sprays  and  douches 

In  using  sprays  for  the  nose,  throat,  or  ears, 
they  should  be  given  very  gently  and  carefully, 
and  boiled  water  should  always  be  used  to 
dilute  or  mix  any  medication  ordered  by  the 
physician.  When  the  ear  is  irrigated  or 
sprayed,  hold  it  downward,  while  the  stream 
of  fluid  is  directed  carefully  a  little  to  one 
side,  so  as  not  to  strike  directly  against  the 
inner  ear. 

Vaginal  douches  must  always  be  taken  lying 
flat  on  the  back,  so  that  the  water  may  reach  to 
the  inflamed  parts.  A  glass  nozzle  is  the  best 
to  use,  as  it  may  be  boiled  in  soda  and  water 
and  so  kept  perfectly  clean.  A  fountain  syringe 
and  granite  douche-pan  are  necessary.  Any 
medication  ordered  by  the  physician  ought 
to  be  well  mixed  in  a  pitcher  before  being 
poured  into  the  syringe-bag.  This  is  espe- 
cially to  be  noted  in  the  use  of  carbolic  acid, 
as  the  oil  in  the  acid  requires  very  hot  water 
to  dissolve  it,  and  if  it  is  not  thoroughly  mixed, 


ENEMATA  153 

will  burn  the  patient.  It  should,  therefore, 
stand  for  about  twenty  minutes  before  being 
used. 

The  temperature  of  the  water  varies  accord- 
ing to  the  cause  for  which  the  douche  is  given, 
but  the  usual  heat  is  between  100°  and  110°  F. 
When  the  fountain  syringe  is  not  in  use  the 
little  fastening  to  shut  off  the  water  ought  to 
be  removed  from  the  tube,  as,  if  allowed  to 
remain,  it  will  in  a  short  time  cut  through 
the  rubber. 

China  bed-pans  are  the  best  for  service,  as 
they  can  easily  be  kept  clean,  and  do  not  retain 
the  odor  like  the  rubber  and  granite.  Before 
giving  your  patient  the  bed-pan,  warm  it  with 
hot  water  or  hold  it  before  the  fire,  so  that  it 
will  not  feel  chilly,  and  lay  a  folded  napkin 
over  the  end  to  be  slipped  under  the  back.  A 
small  pillow  placed  under  the  small  of  the 
back  while  using  the  bed-pan  will  make  your 
patient  much  more  comfortable  by  removing 
the  strain  caused  by  the  elevated  position. 

Enemata 

Enemata  are  used  for  various  purposes,  and 
every  one  should  know  how  to  give  an  enema 
in  case  of  emergency,  either  as  a  cathartic, 


154  HOME  NURSING 

stimulant,  or  for  nutrition.  For  giving  a  sim- 
ple enema,  a  bulb  syringe  is  used  and  about  a 
quart  of  water,  as  hot  as  you  can  keep  your 
hand  in,  with  a  good  lather  made  from  Castile 
or  ivory  soap.  Never  use  scented  soap  in  giv- 
ing an  enema.  It  is  wiser  to  allow  more  water 
in  the  basin  than  you  actually  need  for  the 
enema,  so  that  the  bulb  of  the  syringe  will 
be  entirely  covered  in  water  all  the  time,  and 
there  will  be  no  danger  of  sucking  air  through 
the  tube  into  the  patient.  A  little  oil  or  vase- 
line is  required  to  rub  on  the  nozzle.  Lay 
your  patient  on  the  left  side,  and  protect  the 
bed  with  a  bath-towel  or  rubber  sheeting. 
Allow  the  water  to  run  through  the  syringe 
first  to  exclude  all  the  air  and  to  leave  no  cold 
water  in  the  tube.  Then  oil  the  nozzle  and 
direct  it  with  your  finger  into  the  rectum  ; 
insert  it  very  slowly  and  gently,  and  without 
pressure,  for  about  three  inches.  Squeeze  the 
bulb  slowly,  and  if  the  patient  complains  of 
pain  (which  will  probably  be  caused  by  the 
gas  in  the  bowels  disturbed  by  the  water), 
before  sufficient  water  has  been  introduced, 
wait  a  few  moments  until  the  pain  ceases, 
without  taking  out  the  nozzle,  and  you  will 
then  be  able  to  give  the  rest  of  the  water. 


ENEMATA  155 

After  removing  the  nozzle,  press  a  towel  against 
the  rectum.  If  the  patient  lies  quiet  and  re- 
tains the  enema  for  five  or  ten  minutes,  you 
will  have  a  good  result. 

When  there  is  a  good  deal  of  constipation 
the  enema  will  be  more  successful  if  given 
in  the  knee-chest  position,  that  is,  with  the 
patient  resting  on  the  knees  and  chest  in  bed, 
the  head  very  low,  and  using  a  long,  flexible 
rubber  rectal  tube  on  the  end  of  the  syringe,  so 
that  the  tube  will  reach  six  or  eight  inches  up 
into  the  bowels.  This  is  called  a  high  enema. 
Adding  olive  oil  and  glycerine  to  the  soapsuds 
will  prove  effective  if  the  simple  enema  is  not 
sufficient.  About  one  ounce  of  oil  and  half  an 
ounce  of  glycerine  is  the  usual  amount.  Cas- 
tor oil  may  also  be  given  this  way ;  but  it  is 
better  to  consult  a  physician  before  using  any 
medication  besides  the  plain  soapsuds. 

Sometimes  the  doctor  orders  an  oil  enema  to 
be  given  first  and  retained  for  an  hour,  fol- 
lowed by  a  simple  soapsuds  enema.  In  that 
case,  four  ounces  of  hot  olive  oil  are  injected 
and  allowed  to  work  slowly  through  the  bowels 
before  giving  the  simple  enema. 


156  HOME  NURSING 


Stimulating 
enemata 


These  are  given  in  cases  of  shock  or  col- 
lapse, and  should  be  very  hot,  as  they  will  be 
more  easily  retained.  The  usual  amount  is 
one  tablespoonful  of  whiskey  or  brandy  to 
four  ounces  of  very  hot  water,  as  hot  as  the 
patient  can  stand.  Coffee  is  sometimes  used 
instead  of  the  water,  or  it  may  be  given  alone. 
Hot  water  should  be  run  through  the  syringe 
first,  that  the  tube  may  be  thoroughly  heated, 
and  the  enema  should  be  given  with  a  long 
flexible  rectal  tube,  as  it  must  go  into  the 
upper  bowel  to  be  retained. 


Nutritive 
enemata 


When  the  stomach  is  much  disturbed  during 
a  severe  illness  so  that  food  cannot  be  digested, 
or  in  cases  of  delirious  patients,  and  after  some 
operations  about  the  mouth  and  throat,  nutri- 
tive enemata  are  given  to  nourish  the  system. 
They  are  sometimes  kept  up  for  days  and 
weeks.  Various  formulae  are  used;  one  of  the 
best  is :  Peptonized  milk,  two  ounces ;  one 
tablespoonful  of  whiskey,  and  one  egg  beaten 
up  with  a  pinch  of  salt.  Beef-tea  and  beef 


STARCH  ENEMATA  157 

juice  may  also  be  given  according  to  the 
physician's  orders.  When  this  is  the  only 
form  of  nourishment  taken,  it  must  be  given 
every  four  hours,  day  and  night,  and  a  simple 
soapsuds  enema  is  necessary  once  a  day  at 
least  to  wash  out  the  lower  bowel. 


Starch 
enemata 


In  cases  of  acute  diarrhoea  these  enemata 
are  sometimes  ordered,  and  are  made  by  mix- 
ing a  dessertspoonful  of  starch  with  cold  water 
into  a  smooth  paste  and  then  adding  three 
ounces  of  boiling  water. 

After  using  syringes  of  any  kind  they  must 
be  properly  cared  for  if  you  want  them  to  last 
any  length  of  time,  as  the  rubber  cuts  very 
easily.  When  they  are  well  washed,  aired, 
and  dried,  rub  them  over  with  a  little  oil  or 
vaseline  before  returning  them  to  their  box. 
Then  you  will  be  able  to  keep  the  rubber  soft 
and  pliable.  The  nozzle  should  be  boiled  fre- 
quently in  washing  soda  and  water,  and,  after 
an  infectious  disease,  the  nozzle  should  be 
destroyed,  and  the  syringe  itself  boiled  in  a 
solution  of  carbolic  acid  for  an  hour. 


CHAPTER  IX 

How  to  prepare  for 
a  surgical  operation 

In  these  advanced  days  when  surgery  is  used 
so  generally  and  so  effectually,  it  is  almost  a 
necessity  to  know  something  about  the  prepa- 
rations necessary  for  a  surgical  operation  at 
home.  It  sometimes  happens,  more  especially 
in  the  country,  that  a  sudden  emergency  calls 
for  an  operation  where  the  presence  of  a  trained 
nurse  is  an  impossibility.  I  will  therefore 
devote  this  chapter  to  a  short  description  of 
how  to  provide  for  such  an  emergency. 

If  the  operation  is  to  be  in  the  early  morning, 
have  everything  on  hand  the  night  before,  if 
possible,  so  that  neither  doctors  nor  patient 
may  be  kept  waiting.  Almost  every  surgeon 
has  a  list  of  what  he  will  require  you  to  pro- 
vide in  especial  cases,  therefore  I  will  only  give 
a  general  idea  of  the  things  that  are  always 
necessary.  I  shall  not  enter  into  the  prepara- 
tions needed  for  a  major  operation,  as  in  that 
case,  if  a  nurse  is  not  available,  the  doctor  will 
168 


PREPARATION  OF  THE  ROOM  159 

most  likely  take  his  patient  to  the  nearest 
hospital,  or  else  superintend  the  preparations 
himself. 


Necessary 
appliances 


The  ordinary  things  required  at  every  opera- 
tion are  :  A  firm  kitchen  table,  two  or  three 
small  tables,  three  large  china  hand-basins  and 
two  small  ones,  two  large  pitchers  for  hot 
water  and  one  small  one,  an  old  rug  or  spread 
to  cover  the  carpet,  three  clean  cot'ton  sheets 
and  a  small  blanket,  as  many  towels  as  can  be 
spared,  or,  at  the  least,  two  dozen  and,  if  possi- 
ble, without  fringe,  a  new  wooden  nail-brush, 
two  slop-jars  or  pails,  a  piece  of  rubber  sheet- 
ing and  a  fountain  syringe,  a  bottle  of  bichlo- 
ride tablets,  five  or  six  ounces  of  pure  carbolic 
acid,  and  a  bottle  of  alcohol. 


Preparation 
of  the  room 


In  choosing  a  room  for  the  operation  the 
first  consideration  is  light,  as  the  more  light 
you  are  able  to  have  the  better.  If  possible, 
have  a  room  adjoining  the  bedroom  which  the 
patient  will  occupy  afterward.  If  this  cannot 


160  HOME  NURSING 

be,  and  you  are  obliged  to  use  the  bedroom 
itself,  push  the  bed  into  a  corner  and  remove 
all  unnecessary  furniture.  When  the  opera- 
tion is  to  be  a  major  one,  the  carpet  must  be 
taken  up,  and  the  floor  washed  over  with  soap 
and  water  before  commencing  the  arrangement 
of  the  room.  In  these  cases  no  rug  or  spread 
will  be  necessary  on  the  floor ;  but  if  the  opera- 
tion is  a  minor  one,  the  carpet  can  be  well 
swept  and  the  room  dusted  with  a  damp  cloth, 
and  then  the  covering  laid  ddwn  over  the 
carpet  right  in  front  of  the  largest  window,  and 
over  that  a  large  cotton  sheet.  A  tack  put  in 
each  corner  will  keep  the  sheet  in  place  with- 
out injuring  it. 

In  the  middle  of  the  sheet  place  the  kitchen 
table,  which  is  to  be  covered  first  with  a  heavy 
blanket,  then  the  piece  of  rubber  sheeting 
pinned  firmly  at  the  four  corners  with  safety- 
pins,  and  covered  with  a  clean  sheet.  A  small 
pillow  is  placed  at  one  end,  and  a  sheet  and 
small  blanket  laid  on  top  ready  to  spread  over 
the  patient. 

On  each  side  of  the  large  table  put  the  small 
ones,  two  at  one  side  and  one  at  the  other, 
leaving  room  to  walk  between.  Cover  the 
little  tables  with  clean  white  towels,  and  if 


PREPARATION  OF  THE  ROOM  161 

they  have  polished  tops,  put  under  the  towels 
a  piece  of  oilcloth  or  rubber  sheeting.  A 
couple  of  plain  chairs  are  needed  in  the  room 
in  case  the  surgeon  requires  to  operate  sit- 
ting down.  On  one  of  the  small  tables  put 
two  china  basins,  thoroughly  cleaned,  first 
with  carbolic  solution,  ^,  and  rinsed  off  with 
boiled  water ;  these  are  for  washing  the 
sponges  the  surgeon  will  provide.  The  third 
basin  is  for  sterilized  towels.  One  slop-jar 
is  needed  under  or  beside  the  large  table, 
and  the  other  near  the  table  that  holds  the 
sponges. 

The  window  curtains  must  be  either  tied  far 
back  or  taken  down,  to  give  plenty  of  light. 
Then  fasten  a  small  piece  of  thin  muslin  or 
cheese-cloth  over  the  lower  sash  of  the  window 
for  protection  from  curious  outsiders.  A 
strong  screw  fastened  at  a  convenient  height 
in  the  wall  near  the  window  will  be  needed  to 
hang  up  the  fountain  syringe  that  will  be  filled 
with  sterilized  water,  unless  the  surgeon  re- 
quires some  solution  in  it  to  irrigate  the  wound. 
A  bureau  or  table  covered  with  a  clean  towel 
may  be  utilized  to  hold  the  dressings. 

The  surgeon  will  bring  the  instruments, 
dressings,  and  anaesthetic,  and  should  he  not 


162  HOME  NURSING 

bring  an  ether  cone,  one  may  be  quickly  made 
with  a  newspaper  folded  inside  a  clean  towel. 
The  room  must  be  about  the  temperature  of 
70°  F.  and  well  aired. 

Sterilized  water 
and  towels 

Plenty  of  boiling  water  will  be  required, 
and  the  wash-boiler  is  the  best  thing  in  which 
to  boil  it,  after  it  is  well  scrubbed  with  sapolio 
and  ammonia  inside  and  out.  One  boiler  full 
of  water  should  be  prepared  in  time  to  cool 
before  the  operation,  and  a  second  boiler  full 
will  be  required  steaming  hot.  The  water 
must  boil  for  about  half  an  hour  to  be  well 
sterilized.  The  towels  can  be  sterilized  either 
wet  or  dry,  whichever  the  surgeon  prefers. 
To  sterilize  them  wet,  pin  them  up  in  a  large 
towel  and  put  them  in  a  granite  sauce-pan 
completely  covered  with  water,  and  let  them 
boil  about  half  an  hour.  Then  lift  them  on 
a  dish  and  carry  to  the  operating  room  without 
removing  the  outer  towel  until  you  are  ready 
to  wring  them  out  with  hands  perfectly  steril- 
ized. 

If,  on  the  other  hand,  the  surgeon  prefers 
dry  towels,  pin  them  up  in  a  towel  and  put 


STERILIZED   WATER  AND  TOWELS       163 

them  in  the  oven  on  a  dish.  The  oven  must 
not  be  too  hot,  and  you  need  to  watch  them  to 
see  that  they  do  not  burn.  Leave  them  in  the 
oven  two  or  three  hours. 

In  these  advanced  days  surgeons  prefer  to 
use  plain  sterilized  or,  as  it  is  usually  called, 
boiled  water  almost  entirely  instead  of  any 
antiseptic  solution  ;  but  if  solutions  are  re- 
quired, they  can  be  made  in  a  few  moments 
when  there  is  a  plentiful  supply  of  sterilized 
water.  The  two  solutions  most  likely  to  be 
called  for  are  bichloride  of  mercury  and  car- 
bolic acid.  It  is  well  to  make  a  yoW  solution 
of  bichloride  and  then  dilute  it  as  required. 
One  little  bichloride  tablet  added  to  a  pint  of 
water  will  make  a  YtrVff  s°lution.  Six  teaspoon- 
fuls  of  pure  carbolic  acid  added  to  one  pint 
of  water  will  make  about  a  5  per  cent  or  ^ 
solution. 

A  little  pure  vaseline  or  cold  cream  will  be 
needed  to  rub  on  the  face  round  the  nose  and 
mouth  before  using  the  anaesthetic,  to  prevent 
it  burning  the  skin. 

The  new  nail-brush,  together  with  a  basin 
of  gftlftQ  bichloride  solution,  some  alcohol,  and 
clean  towels,  should  all  be  conveniently  placed 
in  the  bath-room  for  the  surgeon's  use. 


164  HOME  NURSING 

Many  surgeons  order  a  can  of  oxygen,  so  as 
to  have  it  on  hand  in  case  of  emergency,  and 
it  should  be  tried  before  the  operation  to  be 
sure  that  it  is  in  working  order  and  ready  at 
a  moment's  notice. 

Surgical  bed 

Now  that  the  room  is  arranged,  we  will  at- 
tend to  the  bed.  For  surgical  cases  a  simple 
iron  bedstead  is  always  best,  but  this  is  not  an 
absolute  necessity  except  for  a  major  operation. 
First,  put  on  the  under  sheet  very  smooth  and 
tuck  it  in  tightly  across  the  middle  of  the  bed, 
covered  with  a  rubber  draw-sheet,  and  both 
firmly  fastened  to  the  mattress  with  safety- 
pins,  as  an  ether  patient  is  sure  to  be  restless 
and  will  toss  the  bedclothes.  The  top  sheet 
and  blanket  may  be  tucked  in  at  the  foot  of 
the  bed,  and  then  turned  back  well  down  to  the 
bottom  ready  for  the  patient.  Another  blanket 
must  be  placed  under  the  top  sheet,  so  that  the 
patient  may  have  some  extra  warmth  for  the 
first  few  hours.  One  or  two  hot  water  bags 
are  then  placed  in  the  centre  and  covered  with 
a  blanket,  but  they  should  be  removed  from 
the  bed  as  soon  as  the  patient  is  put  in  it, 
and  not  replaced  until  he  is  completely  out 


THE   PATIENT  165 

from  under  the  influence  of  the  anaesthetic. 
So  many  accidents  have  occurred  with  hot 
water  bags  or  bottles  burning  a  patient  while 
unconscious,  that  the  majority  of  surgeons 
refuse  to  allow  them  to  be  put  in  the  bed 
until  the  patient  is  quite  conscious.  When 
they  are  replaced,  they  must  be  carefully 
watched  and  put  at  some  distance  from  the 
patient. 

No  pillow  will  be  necessary  on  an  ether  bed, 
as  the  head  must  be  kept  very  low  on  account 
of  the  nausea,  but  a  towel  is  laid  at  the  head, 
and  a  few  extra  ones  will  be  needed,  with  a 
small  basin,  in  case  of  vomiting. 

The  patient 

Last,  but  not  least,  the  patient  must  be  ready 
when  the  surgeon  arrives.  He  will  probably 
order  a  cathartic  the  night  before,  and,  if  neces- 
sary, an  enema  in  the  morning.  No  breakfast 
is  allowed  if  the  operation  is  in  the  morning, 
except  a  cup  of  bouillon  or  coffee  taken  about 
four  hours  before  the  operation.  If,  however, 
the  operation  is  to  be  in  the  afternoon,  a  light 
breakfast  of  coffee  and  toast  is  the  rule.  In 
some  cases,  if  the  patient  is  very  nervous  and 
faint,  a  couple  of  teaspoonfuls  of  whiskey  or 


166  HOME  NURSING 

brandy  in  water  is  allowed  an  hour  before  the 
operation,  but  not  without  the  surgeon's  per- 
mission. 

The  hair,  if  long,  should  be  neatly  braided, 
and  the  clothing  consist  of  undervest,  drawers, 
nightgown,  wrapper,  stockings,  and  slippers. 
The  wrapper  and  slippers  are  to  be  removed 
and  the  bladder  emptied  just  before  the  anaes- 
thetic is  administered. 

Have  a  little  whiskey  in  readiness  in  case 
of  collapse,  when  it  would  be  necessary  to  give 
a  stimulating  enema,  and  aromatic  spirits  of 
ammonia  or  smelling  salts  which  will  be  of 
service  in  controlling  the  nausea. 

After  care  of  the 
patient 

When  the  operation  is  concluded,  and  the 
patient  in  bed,  remove  any  clothing  that  may 
have  become  wet  or  damp,  make  the  patient 
warm  and  as  comfortable  as  possible,  and  darken 
the  room.  Some  one  must  remain  beside  the 
bed  until  the  patient  is  perfectly  conscious, 
especially  when  the  nature  of  the  operation  is 
such  that  any  sudden  movement  might  cause 
a  hemorrhage.  The  head  must  be  kept  very 
low  to  prevent  nausea,  and  the  pulse  and 


AFTER  CARE  OF  THE  PATIENT  167 

respiration  carefully  watched.  If  the  nausea 
be  very  great  an  ice-compress  on  the  throat 
often  relieves  it,  but  it  will  gradually  pass  off, 
and  as  soon  as  the  vomiting  stops  you  can 
commence  giving  a  teaspoonful  of  very  hot 
water,  as  hot  as  your  patient  can  take  it. 
This  you  will  find  better  than  anything  else 
to  settle  the  stomach  and  remove  the  intense 
dryness  of  the  mouth  produced  by  the  ether, 
and,  in  addition,  it  will  be  found  refreshing  and 
stimulating.  Begin  with  one  teaspoonful  and 
double  it  in  half  an  hour  if  the  nausea  does 
not  return.  Some  doctors  recommend  small 
pieces  of  ice  instead  of  the  hot  water,  but  I 
have  always  found  that  the  hot  water,  if  very 
hot,  not  lukewarm,  answers  the  purpose  better. 
Hot  water,  increased  gradually  to  a  small  tea- 
cupful,  if  desired,  every  one  or  two  hours,  is 
all  that  is  required  in  the  way  of  nourishment 
for  at  least  twelve  hours  after  the  operation. 
The  surgeon  will  give  special  instruction  in 
regard  to  medication  and  diet  to  suit  the  case, 
and  his  orders  ought  to  be  written  down  and 
not  trusted  to  the  memory. 


168  HOME  NURSING 

Hemorrhage 

One  of  the  most  important  complications  to 
watch  for  immediately  after  an  operation  is 
hemorrhage.  The  outside  dressing  of  the 
wound  should  be  looked  at  very  frequently  to 
notice  if  there  is  any  appearance  of  blood  and 
if  it  increases.  If  a  hemorrhage  should  occur 
during  the  surgeon's  absence,  you  must  do  all 
in  your  power  to  check  it  while  awaiting  his 
arrival.  Do  not  allow  your  patient  to  get  wor- 
ried or  excited,  and  remain  as  quiet  as  possible 
yourself.  Elevate  the  wounded  part.  If  it  is 
the  arm,  hold  it  above  the  head  ;  if  the  leg, 
support  it  with  pillows.  When  the  wound  is 
in  the  trunk,  elevate  the  foot  of  the  bed  and 
keep  the  head  very  low.  Do  not  give  alcohol 
or  stimulants  of  any  kind,  as  they  only  increase 
the  hemorrhage  by  making  the  blood  flow  more 
rapidly.  Apply  hot  water  bags  to  the  feet  and 
legs.  If  it  is  possible  to  reach  an  artery  above 
the  wound,  firm  pressure  upon  it  will  check  the 
flow.  Firm  but  gentle  pressure  over  the  wound 
with  a  pad  of  gauze  bound  on  tightly  will 
sometimes  help  to  stop  the  hemorrhage.  When 
the  hemorrhage  is  internal  small  pieces  of  ice 
should  be  swallowed  whole,  and  ice-cloths  ap- 
plied over  the  abdomen. 


RULES  FOB  NURSING  169 

Get  ready  some  sterilized  salt  solution,  made 
by  adding  one  teaspoonful  of  fine  table  salt  to 
a  pint  of  water  and  letting  it  boil  for  half  an 
hour,  as  the  surgeon  may  find  it  necessary  on 
his  arrival  to  infuse  it  into  the  veins. 


Rules  for 
nursing 


The  principal  rule  to  be  observed  in  caring 
for  a  surgical  case  is  absolute  cleanliness. 
Everything  about  the  patient  and  bed  must  be 
kept  immaculately  clean,  and  you  should  never 
touch  a  wound,  or  even  the  dressing  on  a 
wound,  without  first  scrubbing  your  hands 
with  soap  and  water,  especially  the  nails,  as, 
they  form  a  great  hiding-place  for  germs,  and 
then  soaking  the  hands  for  two  or  three  min- 
utes in  a  y^Q-  bichloride  solution.  Many  cases 
of  blood  poisoning  have  arisen  from  the  neglect 
of  this  simple  rule  in  regard  to  the  surgical 
cleanliness  of  the  hands.  An  open  wound 
causes  the  patient  to  be  particularly  suscepti- 
ble to  infection,  and  for  this  reason  it  is  also 
necessary  to  be  careful  whom  you  allow  into 
the  sick-room,  and  to  examine  carefully  any 
package  or  papers  of  any  kind  that  come  by 
mail,  for  there  is  always  the  chance  that  they 


170  HOME  NURSING 

may  have  been  sent  from  a  house  where  there 
is  a  contagious  disease. 

If  the  surgeon  has  left  the  wound  open  for 
drainage,  and  there  is  a  great  deal  of  discharge, 
this  will  prove  a  heavy  drain  on  the  system, 
and  therefore  it  will  be  necessary  to  keep  up  the 
patient's  strength  with  extra  attention  to  diet. 
Nourishing  foods  of  all  kinds  will  be  needed, 
and  a  tonic  will  probably  be  prescribed  by  the 
doctor.  For  the  rest,  the  general  rules  for 
nursing  outlined  in  the  first  chapter  apply 
equally  well  in  surgical  work.  A  great  deal 
of  the  ultimate  success  of  an  operation  depends 
upon  careful  nursing  and  cheerful  surround- 
ings, and  the  happier,  brighter,  and  more  com- 
fortable you  make  your  patient,  the  quicker 
and  more  complete  will  be  his  recovery. 


CHAPTER  X 

It  is  necessary  to  be  prepared  in  some  meas- 
ure for  the  many  unforeseen  emergencies  which 
are  likely  to  arise  in  the  home  life.  In  case 
of  an  accident,  it  is  the  greatest  relief  to  know 
how  to  be  of  assistance  to  the  sufferer.  So 
many  books  have  been  written  about  "  first 
aid  to  the  injured,"  that  I  will  simply  give  a 
few  home  remedies,  within  the  reach  of  every 
one,  and  which  can  be  easily  carried  out. 

Burns 

There  are  three  classes  of  burns,  and  they 
ought  to  be  treated  according  to  the  class  to 
which  they  belong.  When  the  skin  is  not 
broken,  it  is  called  a  burn  of  the  first  degree, 
and  is  best  treated  by  covering  thickly  with 
bicarbonate  of  soda,  flour,  or  baking  soda,  a 
layer  of  cotton  wool  to  exclude  the  air,  and 
a  bandage  put  on  very  gently. 

Burns   of  the  second   degree  are  so   called 

when  the  outer  skin   is  destroyed.     In   these 

cases  dry  powder  is  not  so  useful,  as   it  will 

adhere  to  the   injured  part   and   become  very 

171 


172  HOME  NURSING 

difficult  to  remove.  When  the  skin  is  broken 
it  should  be  treated  as  a  surgical  wound,  kept 
perfectly  clean,  and,  if  possible,  washed  off 
with  salt  solution  or  boiled  water.  The  burn 
can  then  be  dressed  with  carbolized  vase- 
line, carbolized  olive  oil,  olive  oil  and  lime- 
water,  or,  if  there  is  nothing  else  on  hand, 
pure  vaseline.  Spread  the  dressing  on  a  piece 
of  old,  but  surgically  clean,  linen  ;  apply  it  to 
the  burn,  cover  with  cotton  wool  and  a  loose 
bandage.  Some  authorities  advise  washing 
the  burn  first  with  a  solution  of  bicarbonate 
of  soda  and  water,  as  they  claim  that  it  re- 
lieves the  intense  pain.  When  changing  the 
dressing  on  a  burn,  have  the  fresh  dressing  all 
ready  to  apply  before  removing  the  old  one, 
so  that  no  air  will  touch  the  burn.  The  more 
carefully  you  keep  it  covered,  the  less  pain. 
When  a  blister  has  formed  it  must  be  opened 
before  the  burn  is  dressed.  In  doing  this,  use 
a  pair  of  scissors  that  are  perfectly  clean,  and 
pass  them  for  a  minute  through  the  flame  of  a 
lamp  or  gas-jet,  so  that  there  may  be  no  fear 
of  infecting  the  wound. 

A  burn  of  the  third  degree  is  so  called  when 
the  tissues  are  completely  destroyed,  and  it  is 
wisest  to  apply  only  a  temporary  dressing  while 


SHOCK  173 

awaiting  the  doctor's  arrival.  Even  a  burn 
that  does  not  extend  very  deeply  under  the 
surface  may  be  dangerous.  When  it  covers  a 
large  surface  of  the  body  it  is  often  followed 
by  shock  or  collapse.  If  it  be  at  all  extensive, 
a  physician  should  be  summoned,  as  serious 
complications  frequently  follow,  especially  if 
steam  or  smoke  has  been  inhaled,  and  pneu- 
monia, bronchitis,  or  inflammation  of  the  intes- 
tines are  not  uncommon  results. 

Should  the  clothing  catch  fire,  roll  the  person 
over  and  over  on  the  floor,  and  cover  with  rugs, 
blankets,  or  any  woollen  covering.  If  there 
are  symptoms  of  shock  accompanying  the  burn, 
treatment  for  that  must  be  carried  out  immedi- 
ately,—  before  attending  to  the  wound,  —  as  it 
often  proves  fatal,  especially  with  children. 

I 
Shock 

Shock  and  collapse  are  the  result  of  a  severe 
shock  to  the  system,  caused  by  accident,  serious 
operation,  extreme  fear,  or  sometimes  from 
weakness  during  the  course  of  a  severe  disease. 
The  symptoms  are  :  quick,  weak  pulde  ;  respi- 
ration slow  and  shallow ;  surface  of  the  body 
very  cold,  especially  the  extremities,  and  the 
temperature  below  normal. 


174  HOME  NURSING 

Lay  the  patient  down  flat,  without  raising 
the  head,  elevate  the  foot  of  the  bed,  put  on 
plenty  of  blankets,  and  rub  the  body  all  over 
with  hot  alcohol  or  whiskey.  Apply  hot  water 
bags,  bottles,  or  hot  bricks  to  the  feet  and 
about  the  legs,  and  a  light  hot  water  bag  over 
the  heart.  Avoid  all  noise  or  excitement,  and 
give  a  spoonful  of  hot  coffee  or  hot  whiskey 
and  water  every  ten  or  fifteen  minutes.  Should 
the  patient  be  unable  to  swallow,  administer  a 
stimulating  enema  of  two  tablespoonfuls  of 
whiskey  in  half  a  cup  of  water,  or  else  half 
a  cup  of  hot  coffee  at  about  a  temperature 
of  100°  F. 

There  is  one  important  rule  to  be  remembered 
in  the  treatment  of  shock,  that  is,  if  the  shock 
has  been  caused  by  some  injury  to  the  head,  as, 
for  instance,  a  blow  or  fall,  never  give  alcoholic 
stimulants  of  any  kind  whatsoever,  but  use  in- 
stead strong  hot  coffee,  tea,  or  hot  milk. 

In  all  cases  of  shock  a  physician  should  be 
called  immediately. 

Fainting 

This  can  be  quickly  overcome  by  laying  the 
patient  flat  on  the  ground,  with  the  feet  higher 
than  the  head,  ammonia  or  smelling  salts  held 


NERVOUS  HYSTERIA  — POISONING         175 

in  front  of,  but  not  too  near,  the  nostrils,  loos- 
ening the  clothing  about  the  throat,  opening 
the  windows,  and  sprinkling  a  little  cold  water 
on  the  face.  Alcoholic  stimulants  are  as  a  rule 
unnecessary  ;  spirits  of  camphor  on  a  lump  of 
sugar  or  a  spoonful  of  aromatic  spirits  of  am- 
monia act  instead  as  a  good  heart  stimulant. 

Nervous  hysteria 

In  cases  of  nervous  prostration,  or  with  very 
nervous,  excitable  people,  overtired  or  worried, 
you  may  meet  with  an  attack  of  nervous  hyste- 
ria. It  needs  to  be  treated  in  a  firm  but  gentle 
manner.  A  teaspoonful  of  aromatic  spirits  of 
ammonia  in  a  little  water,  or  a  small  dose  of 
bromide  solution  or  paregoric,  whichever  you 
have  on  hand,  will  help  to  quiet  the  nerves. 
Open  the  windows  wide,  even  in  winter,  and 
when  there  is  an  oppression  on  the  chest  after 
violent  crying,  a  small  mustard  leaf  or  plaster 
applied  for  a  few  moments  has  a  wonderfully 
good  moral  effect. 

Poisoning 

Accidental  poisoning,  which  may  be  caused  in 
various  ways,  needs  generally  the  most  imme- 
diate attention  to  save  life.  These  accidents 


176  HOME  NUKSING 

are  often  caused  by  pure  carelessness  in  the 
giving  or  taking  of  medicine  in  the  dark  or 
without  looking  carefully  at  the  label,  or  by 
leaving  dangerous  drugs  within  the  reach  of 
children. 

When  any  one  is  poisoned,  and  you  are  not 
sure  of  the  antidote,  do  not  hesitate  a  moment, 
but  give  an  emetic  of  some  kind  while  awaiting 
the  arrival  of  the  doctor.  Mustard  and  salt 
will  be  found  in  every  household,  and  are  very 
effective.  For  an  adult  give  a  dessertspoonful 
of  mustard  to  every  glass  of  lukewarm  water. 
Make  the  patient  drink  two  or  three  glasses,  no 
matter  how  he  objects,  and.  then  by  tickling 
the  throat  with  the  finger,  the  irritation  will 
cause  vomiting.  Repeat  in  ten  minutes  so  that 
the  stomach  will  be  thoroughly  emptied.  In 
case  of  children  give  ipecac  instead  of  mustard 
and  water  —  one  teaspoonf ul  every  fifteen  min- 
utes until  vomiting  is  produced.  When  there 
is  any  delay  in  getting  the  mustard  or  salt, 
use  plain,  lukewarm  water  in  large  quantities. 
After  the  stomach  is  thoroughly  emptied,  give 
an  enema  if  the  doctor  has  not  arrived.  When 
the  poisoning  is  caused  by  canned  goods  or  stale 
fish,  give  a  large  dose  of  castor  oil  as  soon  as 
the  vomiting  ceases.  There  are  various  anti- 


POISONING  177 

dotes  to  be  used  according  to  the  poison  that 
has  been  taken,  and  it  is  well  to  have  a  list  of 
them  on  hand. 

The  antidote  for  Acid  Poisons,  such  as  Car- 
bolic Acid,  Nitric  Acid,  Oxalic  Acid,  is  as  fol- 
lows :  After  vomiting  has  stopped,  give  two 
or  three  glasses  of  milk  and  lime-water  ;  no  oil 
of  any  kind,  as  it  would  only  help  to  dissolve 
the  acid. 

For  Irritant  Poisons,  such  as  Tartar  Emetic, 
Arsenic,  Paris  Green,  Rough  on  Rats,  Iodine, 
Iron,  Lead,  Mercury:  Make  the  patient  vomit 
first ;  then  give  plenty  of  milk,  white  of  egg, 
or  flour  and  water. 

For  Alkaline  Poisons,  such  as  Ammonia, 
Lime,  Salt  Petre :  After  vomiting,  give  lemon 
juice  or  vinegar,  followed  by  castor  oil. 

For  Narcotic  Poisons  the  treatment  is  as 
follows  :  — 

Aconite :  Emetic,  then  stimulants  and  hot 
applications. 

Belladonna:  Artificial  respiration,  emetics, 
heat. 

Alcohol :  Cold  to  the  head  and  emetics. 

Digitalis :  Emetics  and  dose  of  tannic  acid. 

Opium :  Emetics,  strong  black  coffee  by  mouth 
and  rectum,  and  active  exercise. 

H 


178  HOME  NURSING 

In  all  poison  cases  give  plenty  of  hot 
water  to  drink,  as  it  flushes  out  the  system 
(as  much  as  three  quarts  is  sometimes  used), 
and  keep  up  the  treatment  without  inter- 
mission, no  matter  what  objection  the  patient 
may  make. 

Care  is  needed  for  the  first  few  days  after 
poison  has  been  in  the  system,  especially  in 
regard  to  diet,  which  should  be  very 'simple. 

Sprains 

Very  hot  water  is  the  best  treatment  for  a 
sprain.  Hold  the  limb  under  running  water 
as  hot  as  can  be  borne  for  about  half  an 
hour,  or  keep  it  covered  in  hot  water,  renewing 
the  water  as  it  cools.  Then  apply  a  moist 
dressing  of  alcohol  and  water  or  arnica,  and 
bandage  firmly,  beginning  at  the  extremity 
and  working  upward  to  a  good  distance  above 
the  sprain.  Moisten  the  dressing  every  two 
hours,  and  the  inflammation  will  subside  very 
quickly.  Repeat  the  bathing  in  hot  water 
morning  and  evening,  and  give  the  limb  per- 
fect rest.  Of  course,  if  within  reach  of  a  sur- 
geon, send  for  one,  as  what  may  at  first  appear 
a  simple  sprain  may  really  lead  to  serious 
trouble,  and  many  surgeons  nowadays  treat  a 


BRUISES  OR  CUTS  179 

sprain  by  putting  the  limb  into  plaster  of 
Paris,  or  bandaging  with  strips  of  adhesive 
plaster. 

Bruises  or  cuts 

Hot  boiled  water  is  the  safest  and  easiest 
remedy  to  apply  to  a  bruise  or  cut,  as  it  fulfils 
all  the  need  of  surgical  cleanliness  and  at  the 
same  time  reduces  inflammation.  Bathe  the 
wound  with  a  piece  of  old  linen  which  has  been 
boiled.  And  if  the  wound  is  an  open  one, 
keep  it  under  water  until  perfectly  clean,  and 
wash  out  all  foreign  bodies  carefully.  If  the 
bleeding  is  troublesome  hold  the  injured  mem- 
ber up  in  the  air,  above  the  head  if  possible  for 
a  few  moments,  at  the  same  time  applying  a 
little  pad  of  linen  pressed  firmly  on  the  wound. 
Dress  it  with  sterilized  linen  or  gauze  (when 
there  is  no  iodoform  gauze  to  be  had)  and 
change  the  dressing  daily.  When  the  skin  is 
not  broken  allow  the  wounded  part  to  remain 
in  hot  water  as  long  as  possible.  The  water 
will  be  very  soothing,  and  a  help  in  subduing 
the  inflammation.  Styptic  cotton,  which  is 
made  up  in  small  boxes,  is  very  useful  in 
dressing  a  cut  or  bruise,  and  will  immediately 
stop  the  bleeding.  It  is  antiseptic  and  heals 


180  HOME  NURSING 

a  wound  very  quickly.  Every  household 
should  have  something  of  this  kind  on  hand 
for  emergencies.  A  friend  of  mine,  who  al- 
ways carries  a  box  of  this  styptic  cotton  with 
her,  found  it  of  untold  value  one  day  when 
the  train  in  which  she  was  travelling  knocked 
down  a  child  on  the  track.  The  little  one 
was  bleeding  profusely  from  a  wound  in  the 
head,  but  the  styptic  cotton  stopped  the  hemor- 
rhage at  once,  and  was  practically  the  means 
of  saving  the  child's  life. 

Hemorrhage  from 
the  lungs 

Although  hemorrhage  from  the  lungs  appears 
very  alarming,  still  it  is  not,  as  a  rule,  a  sign 
of  immediate  danger,  and  can  be  controlled 
with  a  few  remedies.  Give  plenty  of  cracked 
ice  and  a  little  paregoric.  Put  an  ice-bag  on 
the  chest,  or,  if  you  have  no  bag  on  hand,  wrap 
some  ice  in  a  piece  of  rubber  sheeting.  Prop 
up  the  patient  in  bed  and  keep  him  absolutely 
quiet. 

Hemorrhage  from 
the  nose 

This  can  generally  be  stopped  by  putting 
the  patient  flat  on  the  back,  with  hands  held 


FRACTURES  181 

up  over  the  head.  Ice  should  be  applied  to  the 
back  of  the  neck,  bridge  of  the  nose,  and  to 
the  wrists,  and  the  tongue  should  be  pressed 
firmly  against  the  roof  of  the  mouth,  with  a  pad 
of  paper  between  to  increase  the  pressure. 

Should  the  bleeding  point  prove  very  obsti- 
nate, plug  the  nostrils  with  a  bit  of  absorbent 
cotton  or  small  pieces  of  linen  with  a  string 
tied  to  them  for  a  few  hours. 

Frequent  hemorrhages  sometimes  come  from 
great  activity  of  the  brain,  but  more  often 
from  ulcers  or  growths  of  some  kind  in  the 
back  of  the  nose  or  throat  which  should  be 
attended  to. 

Fractures 

There  is  nothing  to  be  done  in  the  case  of  a 
fracture  but  to  keep  the  sufferer  perfectly  quiet 
until  the  doctor's  arrival,  as  it  requires  a  skil- 
ful surgeon  to  set  the  broken  limb  properly.  Do 
not  allow  the  patient  to  move  the  injured  limb, 
as  the  pieces  of  broken  bone  might  easily  break 
through  the  flesh  and  cause  a  compound  frac- 
ture. A  dislocation  must  also  be  left  to  the 
surgeon.  Keep  the  injured  part  covered  with 
ice-cold  cloths  until  his  arrival. 


182  HOME  NURSING 

Sore  eyes 

When  the  eyes  are  sore  or  overtired,  bathe 
them  night  and  morning  with  a  solution  of 
boracic  acid  (one  teaspoonful  of  the  acid  to  a 
pint  of  boiling  water)  or  salt  solution  ;  apply 
with  a  small  piece  of  absorbent  cotton.  Salt 
solution  is  also  of  use  in  strengthening  the 
eyes. 

Sore  eyes  of  any  kind  are  very  contagious, 
so  that  any  piece  of  cotton  or  gauze  used  in 
washing  them  must  be  immediately  burned. 
When  the  eyes  are  inflamed  from  cold  or  any 
other  cause,  cut  some  pieces  of  linen,  about 
two  inches  square,  lay  them  on  ice  in  a  dish, 
and  then  place  them  over  the  eyes,  changing 
them  every  three  minutes,  so  that  they  will 
not  have  time  to  become  warm.  You  will  find 
that  this  treatment  gives  great  relief,  and  it 
reduces  the  inflammation  quicker  than  anything 
else.  Should  lime  accidentally  get  into  the  eyes, 
wash  them  immediately  with  equal  parts  of 
vinegar  and  water,  until  all  the  particles  are 
removed.  Then  bathe  them  well  in  warm 
water,  and  keep  in  a  dark  room  for  a  few  hours. 

When  a  foreign  body  gets  into  the  eye,  do 
not  rub  it  in,  but  pull  the  upper  lid  down  over 
the  lower  two  or  three  times,  and  the  irritating 


EARACHE  183 

little  atom  may  be  left  on  the  cheek.  If  not, 
turn  back  the  upper  lid  over  a  darning  needle 
and  brush  off  the  atom  with  a  corner  of  soft 
linen. 

Earache 

Heat  of  some  kind  is  the  most  direct  cure 
for  earache.  Hot  water  bags,  especially  the 
small,  thin,  black  rubber  ones,  are  very  useful, 
but  should  be  frequently  refilled. 

Salt  heated  in  the  oven  and  put  in  a  flannel 
bag  retains  the  heat  a  long  time,  or  a  piece  of 
hot  flannel  tied  firmly  over  the  ear  is  very 
soothing. 

I  have  cured  earache  in  a  child  with  a  few 
drops  of  laudanum  dropped  on  a  piece  of  cotton 
and  applied  to  the  outer  ear,  and  cotton  satu- 
rated with  equal  parts  of  laudanum  and  glyc- 
erine often  gives  the  greatest  relief.  Should 
these  simple  remedies  not  avail  to  ease  the 
pain,  syringing  the  ear  with  boiled  water  at  a 
temperature  of  108°  to  110°  F.,  every  two  hours, 
will  give  the  greatest  comfort  and  almost 
invariably  stops  the  pain,  but  the  syringing 
must  be  done  most  carefully  and  gently.  A 
teaspoonf  ul  of  boracic  acid  should  be  added  to 
the  boiled  water,  and  a  regular  ear  nozzle  with 


184  HOME  NURSING 

a  fountain  syringe  used,  so  as  to  have  a  con- 
tinuous flow.  Hold  the  ear  downward  and  a 
little  backward  ;  let  the  water  run  very  gently, 
not  straight  into  the  ear,  but  a  little  to  one 
side.  Great  injury  may  be  caused  unless  the 
syringing  be  done  very  carefully  and  slowly. 
A  little  of  the  hot  water  allowed  to  remain  in 
the  ear  for  a  few  moments  is  very  soothing. 
Be  careful  not  to  expose  the  ear  to  any  cold 
air  after  syringing  with  hot  water.  Earache  is 
sometimes  caused  by  an  accumulation  of  wax 
in  the  ear,  and  in  that  case  the  hot  water  will 
cure  it. 

Never  fill  an  ear  with  cotton  wool  when 
there  is  a  running  discharge. 

If  a  foreign  body,  such  as  an  insect,  should 
get  into  the  ear,  a  few  drops  of  hot  sweet  oil 
will  float  it  to  the  surface,  whence  it  can  be 
easily  removed. 


Toothache  or 
faceache 


This  can  be  much  relieved  by  holding  hot 
Pond's  extract  or  hot  water  in  the  mouth  until 
it  becomes  cool,  and  then  taking  a  fresh  mouth- 
ful, keeping  it  up  as  long  as  possible  ;  you  will 
be  surprised  at  the  comfort  and  relief  it  gives. 


FOREIGN  BODIES   IN  THE   THROAT  185 

When  there  is  a  hollow  in  the  tooth,  put  a 
couple  of  drops  of  pure  carbolic  acid,  creosote, 
or  oil  of  wintergreen  on  a  piece  of  cotton  wool, 
and  push  it  firmly  into  the  hole,  taking  care 
not  to  touch  the  gums. 

A  tiny  piece  of  mustard  leaf  applied  to  the 
gums,  or  iodine,  well  painted  on,  will  help  the 
pain  when  it  comes  from  general  faceache. 

When  a  child  gets  something  up  his  nose, 
you  may  dislodge  it  by  making  him  sneeze 
with  pepper  or  snuff. 

Foreign  bodies 
in  the  throat 

It  sometimes  happens  that  a  fish  bone  gets 
stuck  in  the  throat,  and  it  is  impossible  to 
reach  it  with  the  finger.  In  that  case  a  raw 
egg  swallowed  quickly  will  generally  carry  it 
into  the  stomach.  If  a  pin,  a  piece  of  glass, 
or  any  foreign  body  with  a  sharp  edge  is  swal- 
lowed by  mistake,  do  not  give  an  emetic,  but 
make  your  patient  eat  solid  food,  so  that  the 
object  may  become  embedded  in  the  food  and 
carried  out  of  the  system  without  injuring  the 
intestines. 


186  HOME  NURSING 

Hiccoughs 

You  can  often  stop  hiccoughs  by  making  the 
person  sneeze  half  a  dozen  times,  or  letting  him 
sip  water  and  hold  his  breath  as  long  as  pos- 
sible between  each  sip.  Another  method  is  to 
pour  vinegar  on  a  lump  of  sugar  and  swallow 
it  whole. 

Vomiting 

Violent  vomiting  is  often  controlled  by  a 
Seidlitz  powder  divided  into  three  parts,  and 
one  part  taken  every  fifteen  minutes,  at  the 
same  time  a  mustard  paste  should  be  applied 
over  the  pit  of  the  stomach.  I  have  also  found 
burnt  brandy,  a  tablespoonful  at  a  time,  most 
effectual ;  it  can  be  set  on  fire  in  a  silver  spoon 
without  injuring  the  spoon.  Oxalate  of  cerium, 
grains  x,  is  a  simple  remedy,  and  very  useful 
in  controlling  nausea.  A  spoonful  of  boiling 
water  every  ten  minutes  is  of  service  in  set- 
tling the  stomach. 

Stings  of 
insects 

Stings  of  insects  can  be  quickly  cured  by 
an  application  of  ammonia  and  water,  bicarbo- 
nate of  soda,  or  salt  and  water.  Any  of  these 


EPILEPSY  187 

remedies  will   remove  the  pain  and  swelling 
like  magic. 

Should  a  child  be  bitten  by  a  dog,  and  there  is 
any  fear  of  the  dog  being  mad,  and  you  are  out 
of  the  reach  of  a  doctor,  suck  the  wound  at  once 
to  draw  out  all  the  poison  possible.  Then  bind 
the  limb  tightly  between  the  wound  and  the 
heart,  to  prevent  the  poison  being  absorbed  into 
the  system.  The  wound  should  also  be  cauter- 
ized with  pure  carbolic  acid,  nitrate  of  silver, 
or  a  knitting-needle  heated  to  a  white  heat. 

Epilepsy 

This  trouble  is  unfortunately  only  too  com- 
mon, and  it  is  well  to  know  how  to  act  should 
a  fit  occur  in  your  presence.  It  may  come  on 
at  any  time,  and  is  generally,  but  not  always, 
preceded  by  a  peculiar  cry  ;  the  patient  falls 
to  the  ground  unconscious,  and  the  body  is 
rigid  for  a  few  seconds,  and  then  begins  to 
twist  and  jerk. 

Loosen  the  clothing  about  the  neck,  put 
something  between  the  teeth  to  prevent  him 
biting  his  tongue,  and  do  not  try  to  restrain 
his  movements  ;  give  him  plenty  of  fresh  air, 
and  he  will  come  to  in  a  few  moments  and  fall 
into  a  heavy  sleep. 


188  HOME  NURSING 

Asphyxiation 

Accidents  sometimes  arise  from  suffocation 
caused  by  gas,  smoke,  sulphur,  etc.  When 
such  an  accident  occurs,  remove  the  sufferer 
at  once  into  the  fresh  air,  loosen  all  clothing 
about  the  neck  and  chest ;  throw  cold  water 
on  the  face  and  chest.  If  necessary,  artificial 
respiration  must  be  resorted  to  until  natural 
breathing  is  restored. 

Artificial 
respiration 

The  knowledge  of  how  to  keep  up  artificial 
respiration  after  an  accident  has  happened 
from  narcotic  poisoning,  suffocation,  or  drown- 
ing is  of  great  importance  and  has  saved  many 
lives.  Place  the  patient  on  his  back  with  the 
shoulders  slightly  raised ;  pull  out  the  tongue 
and  hold  it  with  a  handkerchief  around  it  tied 
under  the  chin.  Then,  kneeling  at  the  head, 
grasp  the  forearm  between  elbow  and  wrist 
and  draw  the  arms  up  gently  and  slowly  over 
the  head  until  the  hands  touch  behind  the 
head.  Keep  them  there  for  two  seconds,  so  as 
to  allow  some  air  to  enter  the  lungs.  Then 
carry  them  slowly  back  and  press  them  against 
the  sides  of  the  chest  to  expel  the  air.  After 


ARTIFICIAL   RESPIRATION  189 

a  couple  of  seconds  repeat  the  movements,  and 
keep  them  going  at  the  rate  of  sixteen  to  the 
minute  until  there  is  some  sign  of  life.  It  has 
sometimes  been  found  necessary  to  work  thus 
for  a  long  time  before  breathing  is  re-estab- 
lished. 


APPENDIX 

Diet  in  disease 
and  convalescence 

In  all  cases  of  illness,  when  a  physician  is 
in  attendance,  no  food  of  any  kind  should  be 
given  without  his  permission,  as  sometimes 
great  harm  may  be  done  by  giving  what  ap- 
pears to  be  a  very  simple  food,  but  which  in 
reality  is  most  harmful  to  the  patient. 

There  are  some  diseases  in  which  it  is  neces- 
sary to  be  especially  strict  in  the  diet,  as,  for 
instance,  typhoid  fever,  Bright's  disease,  gout, 
and  many  others. 

In  the  following  pages  I  have  given  a  few 
suggestions  that  may  be  of  service  regarding 
nourishment  in  some  of  the  ordinary  cases  of 
illness,  but  as  complications  are  likely  to  arise 
in  any  disease,  the  physician  should  always 
be  consulted. 

When  convalescence  is  reached  after  any  dis- 
ease, as  a  rule  the  patient  is  put  on  "light 
diet,"  the  various  forms  of  which  are  left  to 

191 


192  HOME  NUKSENG 

the  discretion  of  the  nurse,  and  these  sugges- 
tions are  to  assist  the  home  nurse  in  arranging 
some  variety  in  the  food,  and  to  give  her  a 
general  idea  of  the  diet  best  suited  to  the 
disease. 


Fevers 


Physicians  do  not  starve  a  fever  in  these 
days  as  they  used  to  half  a  century  ago ; 
scientific  research  has  shown  that  plenty  of 
nourishment  is  required  to  replace  the  waste 
of  tissue  caused  by  the  fever,  and  also  that 
large  quantities  of  fluid  are  necessary  to  wash 
out  the  kidneys  and  to  reduce  the  temperature. 

During  that  period  of  the  disease  when  the 
fever  is  high,  nourishment  is  given  in  fluid 
form,  such  as  milk  in  its  various  preparations 
—  whichever  agrees  best  with  the  patient, 
as  milk  and  lime-water,  milk  and  Vichy,  pep- 
tonized  milk,  buttermilk,  kumiss,  somal,  etc., 
broths,  light  soups,  beef-juice,  and  gruels. 
The  amount  and  frequency  of  administration 
is  regulated  by  the  physician.  When  the  fever 
declines  light  diet  is  usually  prescribed,  and 
for  the  first  week  at  least  the  solid  food  should 
be  given  at  noon,  or  even  a  little  earlier  in 
the  day,  while  the  temperature  is  low,  as  it 


.  APPENDIX  193 

is  then  more  easily  digested,  and  during  the 
afternoon  and  evening,  when  the  temperature 
is  inclined  to  rise,  nourishment  should  be  given 
in  liquid  form. 

For  light  diet,  during  the  early  days  of  con- 
valescence, soups  thickened  with  rice,  barley, 
or  arrowroot  will  be  more  satisfying  to  the 
patient  than  clear  soups  and  broths.  Fari- 
naceous food,  when  nicely  seasoned  and  care- 
fully cooked,  is  often  acceptable ;  eggs  in 
various  forms,  milk  and  cream  toast,  chicken 
and  beef  jelly,  either  hot  or  cold. 

The  yolk  of  an  egg  well  beaten  with  a  little 
sugar,  an  ounce  of  brandy,  and  some  cinnamon- 
water  is  pleasant  to  the  taste  and  very  nu- 
tritious. 

Lemonade,  not  very  sweet,  when  given  be- 
tween meals  is  easily  digested ;  flaxseed  tea, 
barley-water  flavored  with  lemon,  milk  whey, 
and  the  unfermented  grape-juice  now  used 
extensively,  which  is  delightful  to  the  taste, 
slightly  stimulating,  and  as  a  rule  does  not 
upset  the  stomach.  Drinks  of  this  kind  should 
be  given  frequently,  not  in  large  quantities  at 
one  time,  but  a  few  spoonfuls  at  short  inter- 
vals during  the  day,  as  in  the  latter  case  the 
thirst  is  relieved  more  effectually  than  when 


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a  large  amount  is  given  every  three  or  four 
hours. 

During  convalescence,  coffee  and  tea  are 
generally  allowed  in  small  quantities  when 
there  are  no  nervous  symptoms.  In  regard 
to  alcohol  in  any  form,  that  must  be  left  en- 
tirely in  the  hands  of  the  physician,  as  he  will 
be  the  best  judge  of  what  is  suited  to  the  case, 
and  stimulants  of  any  kind  should  never  be 
given  without  his  permission 

When  resuming  solid  food  after  a  long 
period  of  fluid  diet,  it  must  be  done  very 
gradually,  so  as  not  to  overtax  the  digestive 
organs.  Meat  when  first  given  should  be  in 
very  small  quantities,  either  minced,  chopped 
very  finely,  or  scraped.  Starchy  foods  are  of 
great  service  in  building  up  the  system. 

Typhoid  fever 

Typhoid  fever  requires  a  very  much  stricter 
form  of  diet  than  any  other  fever,  as  from  the 
nature  of  the  disease  the  intestines  are  par- 
ticularly sensitive,  and  the  physician's  orders 
must  be  carefully  adhered  to. 

A  relapse  has  been  known  to  occur  in  typhoid 
fever  at  the  hospital  by  the  patient  eating  a 
small  piece  of  plain  bread  brought  to  him  by 


APPENDIX  195 

some  over-anxious  relative  without  the  knowl- 
edge of  doctor  or  nurse.  As  a  rule,  milk  is 
the  principal  diet  throughout  the  disease,  al- 
though where  milk  does  not  agree  well  with 
the  patient  the  physician  sometimes  finds  it 
best  to  vary  it  by  light  broths  or  gruel,  but 
the  broths  must  be  prepared  most  carefully, 
and  be  entirely  free  from  grease  or  fat. 

When  milk  is  given  exclusively,  an  average 
of  about  four  or  five  pints  in  the  twenty-four 
hours  is  the  rule  if  it  is  well  digested.  In 
most  cases  it  is  necessary  to  prepare  it  in  some 
way,  either  by  diluting  it  with  sterilized  water, 
lime-water,  or  barley-water,  or  where  there  is 
nausea,  using  the  peptonized  milk. 

Typhoid-fever  patients  are  as  a  rule  almost 
ravenous  when  they  commence  to  convalesce, 
and  the  greatest  care  has  to  be  taken  that 
they  do  not  overload  the  stomach  or  eat  any- 
thing that  may  cause  a  relapse.  A  limited 
supply  of  solid  food  must  be  given  even  for 
some  weeks  after  the  temperature  is  perfectly 
normal. 

During  convalescence  from  fevers,  as  soon  as 
the  physician  decides  that  solid  food  is  desir- 
able, some  of  the  following  dishes  may  be  given 
under  the  form  of  light  diet  and  subject  to  his 


196  HOME   NURSING 

approval,  choosing   the  simpler  ones   for   the 
first  few  days. 

Chicken  broth  with  arrowroot  or  rice ;  milk 
or  cream  toast ;  junket ;  scraped  beef  sand- 
wiches, or  scraped  beef  in  balls ;  sago  or  rice 
pudding ;  bread  and  milk  ;  a  little  cooked  fruit, 
especially  baked  apples ;  chicken  and  beef  jelly; 
bouillon  with  an  egg  beaten  up  in  it ;  poached 
or  scrambled  eggs ;  boiled  or  stewed  sweet- 
breads ;  a  little  wine  or  calf 's-foot  jelly ;  cus- 
tard or  tapioca  cream ;  occasionally  a  baked 
potato,  very  mealy  and  soft ;  cocoa  made  with 
equal  parts  of  milk  and  water ;  chicken  panada ; 
cream  of  celery  soup ;  and  later  on  potato  soup 
with  croutons  in  it ;  lightly  broiled  lamb  chops 
or  a  small  piece  of  rare  beefsteak;  game;  creamed 
potatoes  ;  snow  pudding  or  orange  jelly. 


Pulmonary 
tuberculosis 


In  the  treatment  of  pulmonary  tuberculosis, 
or  consumption,  as  it  is  usually  called,  diet  is 
very  important,  as  the  disease  is  generally  of 
such  long  duration  that  plenty  of  nourishment 
is  required  to  keep  up  the  strength,  and  at 
the  same  time  great  care  is  necessary  in  select- 
ing the  best  food  to  suit  each  individual  case, 


APPENDIX  197 

as  dyspepsia  and  diarrhoea  are  two  of  the  most 
frequent  complications  to  be  fought  against, 
especially  in  the  advanced  stages. 

Milk,  fats,  and  oils  should  form  the  principal 
diet;  meat  once  a  day  is  as  a  rule  sufficient, 
and  when  taken  should  be  rare  and  juicy. 
Scraped  beef  or  beef-juice  is  to  be  preferred 
as  the  disease  advances.  The  heartiest  meal 
should  be  taken  early  in  the  day,  as  in  the 
case  of  other  fevers  the  temperature  generally 
rises  toward  evening,  and  that  interferes  with 
digestion.  Rich  cakes,  sauces,  fried  meats, 
and  pastry  should  never  be  given,  but  instead 
cereals  of  all  kinds,  plenty  of  fruit  cooked  or 
raw,  abundance  of  milk  in  every  form,  eggs, 
game,  jellies,  cream,  butter,  and  nourishing 
soups. 

Warm  milk  taken  slowly  between  meals  is 
very  beneficial ;  sometimes  if  it  is  diluted  with 
a  little  hot  water  or  Vichy,  it  agrees  better 
with  the  patient ;  a  pinch  of  salt  added  to  the 
milk  will  also  be  of  service  in  helping  the 
digestion.  Cream  and  hot  water  may  also  be 
recommended. 

After  drinking  milk,  the  mouth  must  be 
thoroughly  rinsed  with  some  simple  mouth 
wash,  otherwise  a  very  unpleasant  taste  will 


198  HOME   NURSING 

remain,  and  is  apt  to  give  the  patient  a  strong 
dislike  to  milk,  even  amounting  to  nausea. 

A  large  amount  of  food  is  required,  as  the 
disease  rapidly  wastes  away  the  tissue,  and 
when  there  is  little  or  no  appetite  extra  nour- 
ishment has  occasionally  to  be  administered 
by  the  stomach  tube  between  meals.  Some 
form  of  light  nourishment  is  advisable  before 
retiring  for  the  night,  and  when  the  patient  is 
troubled  with  heavy  night  sweats  a  good  milk 
punch  made  with  brandy  will  be  found  helpful 
in  controlling  them. 

A  cupful  of  hot  water,  at  a  temperature  of 
140°  F.,  taken  in  sips  half  an  hour  before 
breakfast,  helps  to  stimulate  the  appetite  and 
cleanses  the  stomach. 

Grippe,  bronchitis, 
pneumonia 

During  a  severe  attack  of  grippe,  bronchitis, 
or  pneumonia,  while  the  fever  lasts,  fluids  are 
generally  prescribed  instead  of  solid  food,  choos- 
ing the  kind  that  agrees  best  with  your  patient, 
as  especially  in  pneumonia  the  stomach  is  easily 
nauseated. 

A  raw  egg  taken  from  the  shell  will  help 
to  soothe  the  troublesome  cough  in  bronchitis. 


APPENDIX  199 

Hot  and  cold  drinks  of  various  kinds,  as  already 
described  on  page  192,  should  be  given  very 
frequently. 

After  the  temperature  declines  light  diet  is 
usually  ordered,  as  in  convalescence  from  fever, 
and  even  after  regular  meals  are  established 
extra  nourishment  should  be  taken  between, 
such  as  milk  punch,  eggnog,  cocoa,  bouillon, 
or  milk,  as  the  system  takes  some  weeks  to  re- 
cover its  natural  tone.  In  pleurisy  very  little 
fluid  is  allowed,  and  salty  foods  are  most 
desirable. 


Tonsilitis 


This  disease  calls  especially  for  fluid  diet, 
as  the  difficulty  of  swallowing  will  frequently 
prevent  the  patient  taking  as  much  nourish- 
ment as  is  required.  It  is  best  to  concen- 
trate the  food  as  far  as  possible  into  the 
smallest  amount  of  fluid,  giving  strong  beef 
extracts,  beef -juice  without  being  diluted,  egg 
beaten  up  with  brandy,  and  milk  in  various 
forms. 

In  tonsilitis,  as  well  as  in  many  fever  cases, 
ice-cream  is  generally  well  received  by  the 
sufferer,  as  the  intense  coldness  is  grateful  to 
the  inflamed  throat. 


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Neuralgia 


When  suffering  from  an  attack  of  neuralgia 
all  kinds  of  rich  food  should  be  eaten  :  cream, 
butter,  fat  meats,  plenty  of  vegetables,  eggs, 
milk,  and  meat  of  all  kinds,  besides  nourish- 
ment between  meals.  Tea,  coffee,  confection- 
ery, or  highly  seasoned  foods  are  to  be  avoided. 


Surgical  cases 


Surgical  patients  ought  to  be  well  fed,  as 
wounds  heal  better  and  more  rapidly  when  the 
blood  is  in  good  condition ;  at  the  same  time 
care  must  be  taken  not  to  overload  the  system 
while  the  patient  is  confined  to  bed  and  unable 
to  take  any  active  exercise.  After  minor  oper- 
ations, when  there  are  no  complications,  the 
ordinary  diet  is,  as  a  rule,  resumed  after  the 
first  day,  with  perhaps  a  little  extra  nourish- 
ment between  meals  if  desired  by  the  patient. 
When  there  has  been  very  severe  pain,  or  a 
great  shock,  solid  food  must  be  returned  to 
very  slowly,  as  the  digestion  will  probably  be 
weak  for  some  little  time  ;  and  when  there  has 
been  much  loss  of  blood,  a  large  amount  of 
nourishment  is  required,  which  should  be  given 
largely  in  fluid  form.  In  long  surgical  cases, 


APPENDIX  201 

where  there  is  a  constant  discharge  from  a 
wound,  plenty  of  fresh  vegetables,  fats,  fruits, 
milk,  and  the  most  nourishing  food  is  neces- 
sary to  replace  the  continued  drain  on  the 
system. 

Very  much  the  same  food  that  is  recom- 
mended in  convalescence  from  fevers  may  be 
given  in  the  convalescence  of  surgical  patients, 
but  as  long  as  the  patient  is  confined  to  bed 
the  plainest  food  should  be  chosen,  and  the 
heartiest  meal  taken  in  the  middle  of  the  day. 

Insomnia 

Nervous  people  who  suffer  from  insomnia 
could  be  very  much  benefited  by  careful  atten- 
tion to  diet,  instead  of  having  recourse  to 
hypnotics.  It  is  better  not  to  sleep  on  an 
empty  stomach,  but  always  take  some  light 
food,  as  cocoa,  sandwich,  glass  of  ale  and  a 
cracker,  or  a  glass  of  milk,  either  just  before 
retiring  or  it  should  be  at  hand  to  take  when 
they  become  wakeful  during  the  night.  Be- 
sides their  ordinary  meals,  they  should  if  pos- 
sible take  some  light  refreshment  every  two 
hours  if  the  digestion  is  good,  omitting  tea 
and  coffee  altogether,  and  spending  the  greater 
part  of  the  day  in  the  open  air. 


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Rheumatism, 
gout 


Rheumatism  and  gout  are  among  the  dis- 
eases especially  influenced  by  diet.  In  acute 
cases  of  rheumatism  a  fluid  diet  is  most  suita- 
ble, such  as  gruels,  vegetable  soups,  and  all 
forms  of  milk.  No  alcohol,  but  plenty  of 
acid  drinks,  especially  lemonade  without  sugar. 
When  the  acute  symptoms  subside,  all  varie- 
ties of  cereals  and  farinaceous  foods,  milk  and 
cream  toast,  and  corn-meal  pudding  without 
sugar ;  and  when  the  regular  meals  are  re- 
sumed, oysters,  eggs,  chicken,  spinach,  celery, 
and  fresh  fruits  are  among  some  of  the  best 
foods  to  take.  Rich  jellies,  confectionery  of 
all  kinds,  and  meat  should  be  avoided,  though 
in  chronic  cases  meat  is  usually  allowed  once 
a  day,  while  fish  and  poultry  are  taken  at  the 
other  meals. 

In  all  cases  of  rheumatism  and  gout,  sac- 
charin should  take  the  place  of  sugar,  being 
a  product  of  coal-tar ;  it  is  without  any  of  the 
harmful  effects  of  sugar,  but  supplies  the  neces- 
sary sweet  taste. 

The  gradual  accumulation  of  a  large  amount 
of  uric  acid  in  the  system  generally  ends  in 
an  acute  attack  of  gout,  and  there  are  also 


APPENDIX  203 

many  people  who  suffer  from  chronic  gout  in 
a  greater  or  less  degree.  Whenever  it  is 
found  in  the  system,  even  in  a  light  form, 
especial  attention  must  be  given  to  diet.  Al- 
coholic drinks  of  all  kinds  should  be  avoided 
as  carefully  as  sweets  and  sugar.  Fresh  vege- 
tables, fruit,  with  a  very  small  amount  of 
mutton,  lamb,  or  beef  once  a  day  only,  and 
some  chicken,  toast  or  crackers,  should  form 
a  large  part  of  the  daily  food.  A  stout  per- 
son with  gout  in  his  system  has  to  be  so  care- 
ful of  his  diet  that  meal-time  is  to  him  a  trial 
rather  than  a  pleasure.  Only  just  sufficient 
food  to  sustain  the  body  should  be  eaten. 
Eating  too  much  is  very  harmful ;  three  meals 
a  day,  rather  slender  ones  too,  at  regular  in- 
tervals, are  sufficient,  and  no  eating  between 
meals  should  be  indulged  in.  During  an  acute 
attack  the  diet  is  usually  strictly  laid  out  by 
the  physician  in  charge,  with  plenty  of  water, 
hot  or  cold,  taken  about  half  an  hour  before 
meals,  weak  tea  or  alkaline  drinks,  such  as 
lithia  water,  apollinaris,  etc.,  graham  bread  or 
dry  toast,  farinaceous  foods,  and  some  of  the 
plainest  broths  with  no  fat  or  grease  in  them, 
cocoa  nibs,  and  a  little  tea  or  coffee  sweetened 
with  saccharin.  Shell-fish,  —  except  oysters, 


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which  may  be  eaten  when  the  hard  part  has 
been  removed,  —  rich  salads,  sauces,  or  pastry 
must  be  omitted. 

Chronic  Bright's 
disease 

In  cases  of  chronic  Bright's  disease  rich  food 
of  all  kinds  must  be  avoided,  and  the  diet 
depend  principally  on  vegetables,  poultry,  fish, 
fruit,  etc.  In  an  acute  attack  a  diet  of  milk 
exclusively  for  a  few  weeks  is  sometimes 
ordered,  and  has  to  be  taken  in  large  quanti- 
ties—  about  two  or  three  quarts  in  the  twenty- 
four  hours. 

Indigestion, 
dyspepsia 

Slow  eating  ought  to  be  the  rule  in  all  cases 
of  illness,  but  especially  when  troubled  with 
indigestion  or  dyspepsia,  as  digestion  really 
commences  in  the  mouth  by  the  proper  prep- 
aration of  the  food  to  be  received  into  the 
stomach. 

The  diet  must  be  very  plain ;  all  heavy 
sauces,  rich  pastries,  pickles,  entrees,  and  hot 
breads,  starchy  foods,  shell-fish,  smoked  meats, 
game,  cheese,  acid  fruits,  and  tea,  are  left  out 
of  the  menu. 


APPENDIX  205 

When  the  dyspepsia  is  only  slight,  a  few  fresh 
vegetables  and  a  little  starchy  food  is  allowed. 

Some  of  the  following  dishes  are  the  best 
that  may  be  taken  when  suffering  from  indi- 
gestion :  cereals,  zwieback,  or  graham  bread, 
small  portion  of  butter  or  bacon,  well-cooked 
vegetables  in  limited  quantities,  fresh  fish 
without  sauce,  eggs  lightly  cooked  if  they 
agree  with  the  patient,  broiled  or  roast  meats 
and  chicken,  raw-beef  sandwiches,  kumiss, 
baked  apples,  peaches  and  oranges,  very  weak 
tea  without  milk  or  sugar,  and  postum  cereal 
instead  of  coffee. 

In  very  severe  cases  the  patient  is  put  on  a 
strict  diet  with  but  little  variety.  Food  must 
be  taken  very  slowly,  and  fluids  are  best  be- 
tween meals  instead  of  with  them.  It  is  wiser 
not  to  eat  heartily  when  mentally  exhausted, 
but  to  take  some  light  nourishment,  and  to  rest 
for  half  an  hour,  as  the  food  will  not  digest 
well  when  the  nerves  are  overtired.  All  meals 
should  be  eaten  at  regular  hours,  and,  if  pos- 
sible, with  bright  conversation  at  the  table. 

Constipation 

Chronic  constipation  may  be  largely  the 
result  of  improper  feeding,  and  people  with 


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small  appetites  often  suffer  with  this  trouble, 
especially  when  very  little  fluid  is  taken. 
Eating  hurriedly,  taking  meals  at  irregular 
hours,  and  especially  want  of  proper  exercise, 
all  tend  to  promote  constipation.  Fruits 
should  be  eaten  in  abundance,  as  they  are 
laxative,  also  spinach,  onions,  and  tomatoes, 
while  potatoes,  beans,  or  peas  should  be  in- 
dulged in  very  sparingly.  Tea  is  also  slightly 
constipating,  and  too  much  milk,  sweets,  fried 
foods,  and  eggs.  Graham  bread,  buckwheat 
cakes,  cereals,  apple  cider,  grape-juice,  and  quan- 
tities of  water,  both  with  meals  and  at  other 
times,  especially  on  first  arising  in  the  morning, 
will  be  of  service  in  curing  the  trouble. 


Diarrhoea, 
dysentery 


The  opposite  kind  of  treatment  is  required 
in  cases  of  diarrho3a  and  dysentery  ;  very  little 
food  should  be  taken,  and  especially  no  vege- 
tables or  fruits.  If  possible,  no  food  of  any 
kind  taken  for  the  first  eight  or  nine  hours 
during  an  acute  attack,  commencing  then  with 
a  little  arrowroot  or  barley-water,  boiled  milk 
and  rice,  followed  by  chicken  broth  and  crack- 
ers, and  milk  diluted  with  lime-water. 


APPENDIX  207 

The  return  to  full  diet  must  be  very  gradual, 
starting  with  milk  toast,  chicken,  and  boiled 
rice,  and  perhaps  a  baked  potato. 

With  children,  little  or  no  milk  should  be 
given,  but  instead,  beef-juice,  barley  gruel, 
broths  freshly  made,  or  scraped  beef,  avoiding 
all  patent  foods  or  meat  extracts.  The  nour- 
ishment should  be  administered  in  small  quan- 
tities about  every  two  hours,  so  that  the 
stomach  will  not  be  overcrowded. 

When  diarrhoea  turns  to  dysentery  a  most 
careful  diet  must  be  followed ;  milk,  if  given, 
should  be  sterilized  or  peptonized ;  beef -juice 
or  scraped  beef  is  serviceable. 

During  convalescence  rare  roast  beef,  broiled 
chicken,  dry  toast,  a  little  fish  if  desired. 
Very  small  amounts  of  fluid  should  be  taken, 
and  all  drinking  water  must  be  carefully 
sterilized. 


RECIPES   FOR  INVALID   COOKING 

FOB  FEVERS,    GRIPPE,   BRONCHITIS,   PNEUMONIA 

Beef-tea  jelly 

A  third  of  a  box  of  gelatine  steeped  in  water 
for  about  an  hour  ;  then  pour  over  it  two  cup- 
fuls  of  boiling  hot  beef -tea,  season  to  taste  and 
stand  aside  to  cool  in  small  cups.  Serve  in  a 
dainty  china  saucer  with  toasted  crackers. 

Calfs-foot  broth 

Cut  up  two  calves'  feet  and  put  them  in  a 
saucepan  with  four  pints  of  water,  a  little  car- 
rot, a  few  celery  leaves,  salt,  and  mace.  Boil 
for  three  hours  very  slowly  until  half  the 
.amount  is  boiled  away,  then  strain,  and  if 
desired  add  additional  seasoning. 

Barley  water 

Four  tablespoonfuls  of  pearl  barley,  well 
washed ;  put  in  a  saucepan  and  add  three 
cupfuls  of  water,  boil  for  about  twenty-five 
minutes,  sweeten  and  flavor  to  taste.  (Also 
suitable  in  cases  of  Diarrhoea  and  Dysentery.) 
208 


APPENDIX  209 

Grape-juice 

Tliis  recipe  is  a  very  simple  one  and  may 
easily  be  prepared  at  home. 

The  grapes  must  be  fresh  and  perfectly  ripe, 
and  about  three  cupfuls  of  water  is  allowed  to 
every  quart  of  grapes.  Go  over  the  grapes 
carefully,  picking  off  the  crushed  ones  and  the 
stems.  Put  the  grapes  on  the  fire,  pour  the 
water  over  them  and  allow  them  to  come  to  a 
boil  very  slowly ;  as  soon  as  they  come  to  the 
boil,  take  off  the  fire  and  strain  through  a 
cloth,  then  put  the  juice  back  on  the  fire, 
allow  it  to  come  to  the  boiling  point,  pour  into 
the  bottles  and  cork  tightly.  Self-sealing  jars 
or  bottles  with  a  patent  top  should  be  used. 
They  must  be  kept  in  a  dark,  cool  place. 
(Also  of  great  service  in  Rheumatism  and 
Gout.) 

Gruel,  barley 

One  tablespoonful  of  barley,  well  mixed  with 
half  a  cup  of  cold  water ;  add  to  it  a  little  salt 
and  a  cupful  of  boiling  water.  Cook  for  ten 
minutes  and  then  add  three-quarters  of  a  cup 
of  hot  milk,  sweeten  to  taste,  and  serve  imme- 
diately. (May  be  used  in  Rheumatism.) 


210  HOME  NURSING 

Gruel,  egg 

Beat  up  the  whites  of  three  eggs  to  a  stiff 
froth  and  stir  them  into  a  cupful  of  fresh 
barley  gruel,  allow  it  to  stand  on  the  fire  a  few 
minutes  without  boiling,  then  add  any  flavor- 
ing desired.  Turn  it  into  a  mould,  serve  cold 
with  cream.  (Also  used  in  Pulmonary  Tuber- 
culosis.) 

Gruel  of 

milk  peptonized 

A  cupful  of  rice,  oatmeal,  or  barley  gruel; 
warm  it  on  the  fire  5  then  to  half  a  pint  of 
cold  milk  add  five  grains  of  pancreatic  ex- 
tract and  fifteen  grains  of  soda,  mix  well  to- 
gether and  throw  it  into  the  gruel,  take  off 
the  fire  and  serve  when  cold.  (Useful  for 
Indigestion.) 

Irish  moss  or 
carrageen 

Take  half  a  cupful  of  the  moss,  wash  it  well 
and  let  it  soak  for  a  little  while  in  cold  water ; 
then  pour  off  the  water  and  add  to  it  a  pint 
and  a  half  of  fresh  water,  let  it  boil  for  a  quar- 
ter of  an  hour,  then  strain  and  add  flavoring 


APPENDIX  211 

and  sugar  to  taste.  When  cold  it  will  be 
formed  into  a  jelly.  If  it  is  preferred  as  a 
drink,  add  double  the  quantity  of  water  or  milk. 

Gruel,  oatmeal 

Four  tablespoonfuls  of  oatmeal  mixed  with 
double  the  quantity  of  cold  water.  Put  a  pint 
of  water  in  a  saucepan  with  a  pinch  of  salt,  let 
it  come  to  the  boil,  then  stir  in  the  oatmeal ; 
boil  slowly  for  twenty  minutes,  strain  and 
serve. 

Kumiss 

A  quart  bottle  filled  almost  to  the  top  with 
boiled  milk ;  then  stand  it  aside  until  luke- 
warm ;  add  to  it  a  small  piece  of  yeast  about 
the  size  of  a  nutmeg  and  a  tablespoonful  of 
sugar.  Seal  tightly  and  stand  in  a  cool,  dark 
place,  shake  daily,  and  do  not  use  it  for  a  week. 
(Useful  for  Gout.) 

FOB  RHEUMATISM  AND  GOUT 

Biscuit  soap 

A  large  cupful  of  mutton  broth  or  beef-tea 
and  two  heaping  teaspoonfuls  of  powdered 
biscuit ;  boil  together  for  fifteen  minutes,  stir- 


212  HOME  NURSING 

ring  constantly,  strain  and  serve  hot  with  small 
pieces  of  dry  toast.  (Useful  also  in  conva 
lescence.) 

Blanc-mange 

Add  three  tablespoonfuls  of  gelatine  to  a 
quart  of  new  milk,  boil  until  all  is  dissolved ; 
then  pour  in  a  cupful  of  cream,  sugar  to  taste 
and  any  flavoring  desired,  stir  for  five  minutes 
on  the  stove,  then  throw  in  the  sugar  and  nut- 
meg and  a  little  lemon  if  desired,  pour  into  a 
mould  and  set  on  the  ice  to  cool.  (Useful  also 
in  convalescence.) 

Chicken  puree 

Take  the  white  meat  from  the  breast  of  a 
nicely  roasted  chicken,  and  a  large  tablespoon- 
ful  of  stale  milk-bread  crumbs.  Pound  the 
bread  and  meat  together,  mixing  in  a  little 
chicken  broth  to  moisten  it  to  the  consistency 
of  thick  cream,  flavor  to  taste,  warm  slowly 
and  serve  in  a  small  bouillon  cup.  (Useful 
also  in  Pulmonary  Tuberculosis.) 

Chicken  creamed 

A  tender  young  chicken  cut  up  in  rather 
small  pieces  and  placed  in  a  saucepan,  add  to 


APPENDIX  213 

it  two  pints  of  hot  water,  two  tablespoonfuls 
of  butter,  part  of  an  onion,  pepper  and  salt, 
and  if  desired  a  little  lernon  juice.  Boil  all 
together  until  the  chicken  is  quite  tender, 
cooking  very  slowly.  While  the  chicken  is 
in  preparation  the  sauce  may  be  made.  Take 
four  teaspoonfuls  of  flour  and  the  same  amount 
of  butter,  put  in  a  small  saucepan  on  the  fire, 
rubbing  them  well  together  until  the  butter  is 
dissolved,  then  add  to  it  the  yolk  of  an  egg 
well  beaten  up  and  a  tablespoonful  of  cream. 
When  all  is  well  mixed  together  strain,  and 
laying  the  chicken  on  a  hot  plate,  pour  the 
cream  over  it,  surrounding  the  chicken  with 
some  nicely  boiled  rice  or  mashed  potatoes. 
(May  be  used  also  in  convalescence  and  Pul- 
monary Tuberculosis.) 

Savory  eggs 

Beat  up  two  eggs  with  salt,  pepper,  and  a 
tablespoonful  of  cream.  Melt  an  ounce  of 
butter  in  a  saucepan,'  then  pour  in  the  eggs, 
stirring  constantly ;  as  they  thicken  throw  in 
some  small  pieces  of  tender,  cold  roast  chicken. 
When  all  is  well  mixed  and  piping  hot  serve 
on  buttered  toast.  (To  be  used  also  in  Tuber- 
culosis.) 


214  HOME  NURSING 


Lemon 
sherbet 


The  juice  of  five  lemons,  three-quarters 
of  a  cup  of  sugar,  and  a  pint  of  water  all 
well  mixed  together;  strain  and  freeze  solid 
on  the  ice. 

Oyster  stew 

Mix  half  a  pint  of  milk  with  a  teaspoonful 
of  corn  flour,  boil  until  it  thickens,  stirring 
constantly.  To  this  add  half  an  ounce  of  but- 
ter and  season  to  taste.  Then  throw  in  six  or 
eight  oysters  and  stew  gently  for  twenty  min- 
utes. Serve  on  a  hot  dish  with  some  small 
pieces  of  bread  that  have  been  soaked  in  lemon 
juice  and  toasted,  surrounding  the  oysters. 
(Also  of  service  in  convalescence.) 

Broiled  oysters 
on  toast 

Six  large  oysters  broiled  lightly  before  a  very 
hot  fire ;  have  ready  two  slices  of  rather  thin, 
crisp  toast  nicely  buttered,  put  three  oysters 
on  each  slice,  sprinkle  with  salt,  pepper,  and 
lemon  juice  and  serve  immediately  with  horse- 
radish. 


APPENDIX  215 

Bice  cookies 

Take  half  a  cupful  of  rice  nicely  boiled,  one 
egg,  half  a  teaspoonful  of  butter,  and  half  a 
cup  of  milk,  add  to  this  three  tablespoonfuls  of 
rice  flour  and  a  pinch  of  salt,  mix  all  well  to- 
gether and  bake  in  small  tins.  (May  be  given 
in  convalescence  from  Dysentery.) 

Sago  soup 

Cook  two  tablespoonfuls  of  sago  in  one  cup 
of  water  until  quite  soft,  then  add  the  yolk  of 
an  egg  and  half  a  cup  of  hot  cream.  Have 
ready  a  pint  of  beef  essence  boiling  hot  and 
mix  all  well  together.  (Very  good  in  Tuber- 
culosis.) 

Chicken  jelly 

A  young  chicken  nicely  prepared,  cut  up 
into  small  pieces,  put  in  a  saucepan  with 
three  pints  of  water,  cooked  rather  slowly,  re- 
moving the  grease  from  the  top  continually. 
Allow  it  to  cook  for  about  five  and  a  half 
hours,  season  to  taste  with  salt,  pepper,  celery, 
and  parsley  ;  when  finished  stand  aside  to  cool, 
for  some  hours,  then  skim  the  grease  off  the 
top  and  serve  either  hot  or  cold.  (Used  also 
in  Fevers,  convalescence,  and  Tuberculosis.) 


216  HOME  NURSING 

poached 
with  cream 

Two  eggs  lightly  poached,  place  on  crisp 
toast  on  a  hot  plate  and  pour  over  them  half  a 
cupful  of  hot  cream.  This  makes  a  very  dainty 
and  nourishing  little  dish.  (For  convalescence 
also.) 

FOR  DIARRHCEA  AND  DYSENTERY 

Arrowroot 
blanc-mange 

Mix  two  ounces  of  arrowroot  into  a  smooth 
paste  with  a  little  milk,  sweeten  to  taste,  then 
boil  in  a  covered  saucepan  until  fairly  thick, 
stirring  constantly  to  prevent  burning,  season 
with  vanilla  or  lemon  peel,  turn  into  a  mould, 
and  serve  ice  cold  with  a  little  jelly. 

Arrowroot 
milk 

A  tablespoonful  of  arrowroot  mixed  to  the 
consistency  of  thick  cream  ;  boil  a  cupful  of 
milk  and  stir  in  the  arrowroot,  let  it  boil  for 
five  minutes,  sweeten  to  taste.  Just'  after 
taking  it  off  the  fire  pour  in  half  a  cupful 
of  cream.  (Sometimes  given  in  Fevers  and 
Pneumonia.) 


APPENDIX  217 

Arrowroot 
jelly 

A  dessertspoonful  of  arrowroot,  a  little  nut- 
meg, sugar,  and  half  a  pint  of  water.  Mix 
the  arrowroot  with  a  little  cold  water,  add  the 
remainder  of  the  water  boiling  hot,  stir  briskly 
until  it  comes  to  the  boil,  strain  into  a  bowl, 
and  place  on  the  ice  to  cool. 

Bice  cake 

'  Beat  up  three  eggs  to  a  stiff  froth,  put  them 
in  a  double  boiler,  and  stir  briskly  on  the 
stove  for  eight  minutes,  then  add  slowly  three 
ounces  of  fine  sugar  and  quarter  of  a  cup  of 
ground  rice,  also  flavoring  to  taste.  When  all 
is  well  mixed,  pour  into  a  buttered  pan  and 
bake  in  a  hot  oven  for  twenty  minutes. 

Gruel 
of  rice 

The  same  proportions  used  as  in  making 
oatmeal  gruel,  water  or  milk  may  be  used  in 
mixing ;  and  this  kind  of  gruel  is  of  especial 
service  in  cases  of  dysentery. 

Beef -juice 
on  toast 

Take  three  or  four  ounces  of  freshly  squeezed 
beef-juice,  add  pepper  and  salt  to  taste,  warm 


218  HOME  NURSING 

it  by  putting  the  cup  in  a  bowl  of  very  hot 
water,  then  make  two  slices  of  buttered  toast, 
about  half  an  inch  thick,  put  the  toast  on  a 
hot  plate,  and  pour  the  hot  beef-juice  over  it, 
serve  at  once.  (Very  useful  also  in  conva- 
lescence, and  the  later  stages  of  Pulmonary 
Tuberculosis.) 

FOE  INDIGESTION  AND  DYSPEPSIA 

Oatmeal 
beef-tea 

Make  about  a  quart  of  good  beef-tea ;  after 
straining  add  to  it  half  a  cupful  of  fine  oat- 
meal which  has  been  mixed  to  a  paste  with 
water,  and  season  to  taste.  Boil  until  the 
oatmeal  is  soft,  then  strain  and  serve  either 
hot  or  cold. 

Meat  soup 

Half  a  pound  of  mutton,  veal,  and  beef,  cut 
up  into  small  pieces,  put  into  a  saucepan  with 
one  pint  and  a  half  of  water,  and  a  little  salt. 
Allow  it  to  stew  slowly  for  three  hours,  skim 
frequently;  if  desired,  parsley,  celery,  salt,  or 
other  seasoning  may  be  added.  (For  conva- 
lescence also.) 


APPENDIX  219 

Croutons 

Croutons  make  a  nice  addition  to  soups  or 
broths  for  an  invalid.  To  make  them,  take 
some  slices  of  bread,  rather  stale,  cut  it  up 
into  small  diamond-shaped  or  square  pieces, 
put  them  on  a  tin  plate  in  the  oven  until  quite 
dry  and  crispy,  then  spread  them  on  a  broiler 
over  the  fire  and  toast  quite  brown  ;  should  be 
served  in  the  soup  as  soon  as  toasted  and  not 
allowed  to  stand. 

Oatmeal 
pudding 

Two  large  apples  sliced  into  a  bowl,  half  an 
ounce  of  flour,  and  half  a  pint  of  oatmeal, 
which  has  been  steeped  for  three  hours,  a  pint 
of  water,  sugar  and  salt  to  taste.  Bake  in  a 
quick  oven,  and  serve  hot  with  cream. 

Jelly  made  with 
prepared  milk 

Soak  half  a  box  of  gelatine  for  an  hour  in 
cold  water,  add  to  it  two  ounces  of  boiling 
water,  the  juice  of  an  orange  and  lemon,  and  a 
1  little  lemon  peel,  also  two  ounces  of  rum. 
When  all  is  well  mixed  together  pour  in  a 
cupful  of  peptonized  milk  very  hot,  sweeten 
to  taste  and  strain  into  a  mould. 


220  HOME  NURSING 

Creamed  oysters 
on  toast 

Six  oysters  opened  freshly  into  a  saucepan 
with  their  juice,  an  ounce  of  milk,  salt,  pepper, 
and  mace  to  taste  ;  after  boiling  five  minutes 
add  to  it  a  little  thickening,  made  with  flour 
and  butter  rubbed  together  ;  stir  all  until  well 
mixed,  then  pour  out  on  a  slice  of  crisp  toast, 
and  serve  immediately.  (Convalescence  and 
Tuberculosis  also.) 

Rennet 
custard 

One  quart  of  milk,  two  tablespoonfuls  of 
sugar  and  flavoring  to  taste;  into  this  stir  a 
teaspoonful  of  rennet,  cover  and  stand  in  a 
warm  room.  If  it  does  not  commence  to 
thicken  in  an  hour,  add  a  little  more  rennet. 
Serve  with  whipped  cream.  (Useful  also  in 
the  early  days  of  convalescence.) 

Egg  brandy 

The  white  of  one  egg,  beaten  up  to  a  froth, 
and  add  to  it  two  dessertspoonfuls  of  rich 
cream  and  a  tablespoonful  of  brandy  ;  stir 
briskly  together.  Sweeten  to  taste  and  serve 
ice  cold. 


APPENDIX  221 


Apple 
charlotte 


Butter  a  deep  pie  dish,  then  shake  over  the 
butter  some  granulated  sugar,  cover  the  bot- 
tom of  the  dish  with  thin  slices  of  bread  and 
butter,  on  this  put  a  layer  of  sliced  apples, 
a  little  sugar,  and  few  cloves  ;  add  the  layers 
of  bread  and  apples  until  the  dish  is  full,  the 
top  layer  being  apples ;  put  some  small  pieces 
of  butter  on  top  and  moisten  the  whole  with  a 
little  water,  bake  in  a  tightly  covered  dish  in  a 
slow  oven  until  quite  soft,  then  remove  the 
cover  and  brown  on  the  top.  (Also  for 
Tuberculosis.) 


FOR  PULMONARY  TUBERCULOSIS 


Eggs  poached 
in  broth 


Two  eggs  poached  carefully  in  well-seasoned 
broth  instead  of  water.  Be  careful  that  the 
eggs  do  not  break.  Put  them  on  hot,  buttered 
toast,  and  strain  enough  of  the  broth  over 
them  to  moisten  the  toast.  (May  be  given 
during  convalescence.) 


222  HOME  NURSING 


Thick  milk 


This  is  easily  digested  and  very  palatable. 
Put  a  quart  of  milk  away  in  a  cool  place  in  a 
wide  bowl  until  it  becomes  thick  and  smooth 
like  jelly,  then  set  it  on  the  ice  for  half  an 
hour,  and  serve  it  in  glass  saucers  with  cream, 
sugar,  and  grated  nutmeg. 


Jelly  of 
fresh  fruit 


A  large  cupful  of  clear,  sweet  jelly,  some 
ripe  fruit  (any  variety  you  prefer)  with  stalks 
removed. 

Put  a  little  jelly  at  the  bottom  of  a  bowl ; 
when  it  is  cool  arrange  the  fruit  round  the 
sides  of  the  mould,  then  pour  in  some  more 
jelly  ;  allow  it  to  stand  a  little,  and  add  some 
more  fruit.  Fill  up  the  mould  with  jelly  and 
fruit  in  layers,  then  set  it  on  the  ice  until  cold. 


Tomato 
cream 


One  quart  of  cold  milk  that  has  been  boiled, 
four  eggs  well  beaten,  one  cupful  of  tomatoes 
that  have  been  stewed  and  passed  through  a 
large  strainer,  sugar  to  taste.  Cook  in  a  quick 
oven,  in  small  custard  cups. 


APPENDIX  223 

Egg  cream 

Beat  up  the  yolks  of  two  eggs  until  quite 
frothy,  add  a  dessertspoonful  of  sugar,  juice  of 
half  an  orange,  and  a  little  of  the  rind  grated. 
Place  it  in  a  bowl,  and  stand  the  bowl  in  a 
saucepan  of  boiling  water,  allowing  it  to  cook 
slowly,  stirring  constantly.  At  the  same  time 
have  ready  the  whites  of  the  eggs  beaten  to  a 
stiff  froth,  with  a  little  sugar  and  a  pinch  of 
salt.  When  the  yolks  of  the  eggs  commence 
to  thicken,  throw  in  the  whites,  mix  all  well 
together,  pour  out  into  small  glasses,  and  serve 
cold.  (When  sweetened  with  saccharin,  it  may 
be  given  in  Rheumatism.) 

Sago  jelly 

Half  a  cupful  of  the  juice  of  raspberries,  or 
strawberries,  or  any  other  fresh  fruit,  three- 
quarters  of  a  cup  of  sago  that  has  been  washed 
and  steeped  in  water,  and  a  cupful  of  sugar ; 
boil  all  well  together  until  the  sago  is  soft, 
pour  into  a  mould,  and  set  on  the  ice  to  cool. 

Sandwiches 
of  fruit 

Chop  up  some  fruit  into  small  pieces,  any 
kind  preferred,  dates,  raisins,  candied  cherries, 


224  HOME  NURSING 

oranges,  lemons,  bananas,  etc.,  moisten  with  a 
little  orange  juice,  spread  on  very  thin  bread 
and  butter,  and  cut  into  small  squares. 


Scalloped 
oysters 


Butter  a  small  pie  dish,  and  put  in  a  layer  of 
bread  crumbs  and  then  a  layer  of  oysters  up  to 
the  top  of  the  dish,  the  top  layer  being  bread 
crumbs.  Add  salt  and  pepper  to  taste,  and  on 
the  top  a  small  piece  of  butter.  Moisten  with 
the  juice  of  the  oysters,  and  bake  in  a  quick 
oven  for  ten  or  fifteen  minutes.  (Very  deli- 
cious during  convalescence.) 

Banana 
cream 

Take  the  skin  off  six  bananas  and  cut  them 
up  into  a  saucepan  with  half  an  ounce  of  gela- 
tine that  has  been  dissolved  in  half  a  cup  of 
water,  add  the  juice  and  peel  of  a  lemon,  and 
sugar  to  taste.  Cook  gently  for  ten  minutes, 
and  then  pour  into  it  a  cupful  of  cream,  beat 
all  well  together,  and  set  in  a  mould  to  cool. 

Panada 

Wash  well  two  ounces  of  pearl  barley  or 
rice,  put  it  into  a  saucepan  with  half  a  pound  of 


APPENDIX  225 

mutton  or  veal  cut  in  small  pieces,  and  half  a 
pint  of  water.  Allow  it  to  simmer  slowly  for 
two  hours ;  then  pound  it  up  and  pass  it 
through  a  fine  sieve,  add  a  little  cream,  and 
serve  hot  or  cold. 

FOR  CONVALESCENCE 
Egg  caudle 

A  cupful  of  nicely  cooked  oatmeal  gruel, 
tablespoonful  of  sherry,  well-beaten-up  egg, 
lemon  flavoring,  sugar  to  taste.  Stir  well 
together,  serve  either  hot  or  cold. 

Meat  minced 

Heat  four  tablespoonfuls  of  minced  meat 
with  a  little  hot  water,  salt  and  pepper,  and 
other  seasoning  if  desired.  Add  to  it  one 
ounce  of  fine  bread  crumbs,  mix  well  together, 
and  bake  on  a  buttered  dish  for  eight  minutes 
or  until  brown  on  the  top. 

Sweetbreads 
baked 

Prepare  the  sweetbreads  carefully,  then  dip 
them  in  a  mixture  of  cracker  crumbs  and  egg ; 
cook  slowly  for  nearly  an  hour  on  a  pan  with 
plenty  of  melted  butter  poured  over  them ;  the 

Q 


226  HOME  NURSING 

oven  should  be  pretty  hot,  and  they  should  be 
turned  frequently.  (Also  given  in  Tuber- 
culosis.) 

Lemon  jelly 

A  cupful  of  sugar,  the  juice  and  rind  of  two 
lemons,  one  pint  of  water,  and  one  ounce 
of  isinglass.  Boil  for  fifteen  minutes,  strain 
through  a  jelly  bag  into  a  mould,  and  place 
it  on  the  ice  to  cool. 


Cream 
custard 


Half  a  pint  of  milk  and  a  quarter  of  a  pint 
of  rich  cream,  half  an  ounce  of  flour,  sugar 
to  taste,  and  any  flavoring  desired.  Mix 
the  flour  and  cream,  add  the  milk  boiling 
hot,  then  put  in  the  flavoring  and  sugar. 
Pour  into  a  dish  and  bake  a  light  brown 
on  top. 


Egg 
lemonade 


The  juice  of  a  lemon  and  a  little  of  the 
grated  peel ;  put  into  a  glass,  with  sugar  to 
taste.  Pour  over  it  half  a  cup  of  boiling 
water ;  allow  it  to  stand  until  cool.  Strain 
into  another  glass,  beat  up  an  egg  with  a 


APPENDIX  227 

tablespoonful  of  sherry  to  stiff  froth,  and  mix 
it  well  with  the  lemon  and  water. 


Tapioca 
custard 


Two  pints  of  milk  allowed  to  reach  the 
boiling  point,  then  add  the  yolks  of  three 
eggs  well  beaten,  and  one  ounce  of  tapioca 
that  has  been  steeping  for  twelve  hours  in 
milk,  sweeten  to  taste.  Mix  all  well  together, 
when  it  commences  to  thicken  turn  it  out  in  a 
dish  and  spread  on  the  top  the  whites  of  the 
eggs  beaten  to  a  stiff  froth  with  a  little  sugar, 
then  place  the  dish  in  the  oven  for  five  minutes 
to  brown.  Serve  either  hot  or  cold. 


Raspberry 

cream 


Take  half  an  ounce  of  gelatine,  put  it  into  a 
bowl ;  add  enough  milk  to  cover  it,  and  allow 
it  to  stand  for  half  an  hour.  Then  pour  over 
it  a  cupful  of  boiled  milk  sweetened  to  taste, 
add  to  this  a  pint  of  fresh  raspberries  which 
have  been  cooked  with  a  little  sugar,  and  strain 
through  a  fine  cloth.  Stir  in  a  cup  of  cream, 
beat  all  together  until  thick,  then  pour  it  into 
a  mould  and  place  on  the  ice. 


228  HOME   NURSING 


Custard 
boiled 


Put  one  pint  of  milk  into  a  white  porcelain 
saucepan  with  two  ounces  of  sugar  and  the 
rind  of  half  a  lemon  j  allow  the  milk  to  stand  on 
the  back  of  the  stove  until  well  flavored  with 
the  lemon,  then  put  it  on  front  of  the  stove  ; 
allow  it  to  come  almost  to  a  boil  and  strain  into 
a  bowl.  When  it  has  become  cool  stir  in  three 
well-beaten  eggs,  then  put  the  bowl  in  a  sauce- 
pan on  the  fire  and  stir  constantly  one  way 
until  it  thickens,  but  on  no  account  allow  it 
to  boil  or  it  will  curdle.  Pour  into  custard 
glasses  and  grate  nutmeg  on  the  top. 


Coffee 


To  make  a  good  cup  of  coffee  for  an  invalid 
put  about  eight  teaspoonfuls  of  coffee  (Java 
and  Mocha  mixed  is  the  best)  into  a  granite 
coffee-pot,  and  pour  on  it  a  large  cupful  of 
boiling  water ;  then  place  it  on  the  stove  until 
it  comes  to  the  point  of  boiling,  pour  in  a 
second  cup  of  boiling  water,  allow  it  to  come 
almost  to  boiling  point  again,  then  stand  it 
aside  to  settle,  and  serve  immediately  with 
cream. 


APPENDIX  229 


Tea  for 
invalids 


The  water  must  be  freshly  boiled  and  on  the 
boil  when  the  tea  is  made.  An  earthenware 
tea-pot  is  the  best  to  use ;  first  scald  it 
with  the  boiling  water  before  putting  in  the 
tea  —  a  very  important  point  to  observe.  The 
amount  of  tea  varies  according  to  the  quality ; 
as  a  rule,  one  teaspoonful  for  each  cup,  and  if 
more  than  three  cups  are  made  an  extra  spoon- 
ful is  allowed.  After  pouring  on  the  water 
the  tea  should  only  stand  for  five  minutes. 
Serve  on  a  tray  covered  with  a  snowy  napkin, 
with  a  dainty  cup  and  saucer,  tiny  cream 
pitcher,  sugar  bowl,  and  small  pitcher  of  hot 
water.  Put  some  of  the  boiling  water  in  the 
cup  to  heat  it,  and  allow  the  patient  to  pour  it 
out  herself. 


INDEX 


A. 

Artificial  respiration,  188. 
Asphyxiation,  188. 

B. 

Baths,  63. 

cold,  64 

foot,  69. 

hot,  65,  Ti. 

in  bed,  67. 

mustard,  70. 

salt,  73. 

sponge,  71. 
Bath  mittens,  75. 
Bed,  3. 

arrangement  of,  3. 

making,  4. 

mattress,  3. 

sheets,  4,  19. 
Bed-pan,  13,  94,  163. 
Bed-rest,  21. 
Bed-sacks,  17. 
Bed-sores,  4,  22. 

prevention,  22. 

treatment,  23. 
Bedstead,  2. 

Bichloride  of  mercury,  92. 
Blisters,  146. 
Bronchitis,  63. 
Bruises  or  cuts,  179. 
Burns,  171. 


C. 

Carbolic  acid,  92. 
Care  of  sick  children,  106. 
Chapped  hands,  75. 
Children's  diseases,  108. 
Cold  applications,  160. 
Cold  compresses,  150. 
Complications  after  fevers,  102. 
Constipation  in  children,  108. 
Convalescence,  26. 
Convulsions,  113. 
Coughs  and  colds,  44. 

prevention,  45. 

treatment,  46. 
Counter-irritants,  151. 
Croup,  109. 

D. 

Daily  record,  96. 
Diarrhoea,  114. 
Diphtheria,  80,  82,  09. 
Doses  of  medicine,  41. 
Douches,  152. 
Dry  heat,  148. 

E. 

Earache,  183. 
Emergencies,  171. 
Enemata,  153. 
high,  165. 
nutritive,  166. 
231 


232 


INDEX 


Enemata,  oil,  155. 

simple,  154. 

stimulating,  156. 
Epilepsy,  187. 

F. 

Faceache,  184. 

Fainting,  174. 

Fall  or  blow  on  the  head,  117. 

Fevers,  79. 

infection,  79. 

symptoms,  81. 

isolation,  82. 

contagion,  83. 

disinfection,  99. 
Flowers,  14. 

Foreign  bodies  in  the  throat,  185. 
Formalin,  92,  102. 
Fractures,  181. 

G. 

Gastric  catarrh,  116. 
Germs,  79,  80,  88. 
Grippe,  50. 

prevention,  50. 

treatment,  61. 

H. 

Headache,  94. 
Heat,  7. 
Hemorrhage,  168. 

from  the  lungs,  180. 

from  the  nose,  180. 
Hiccoughs,  186. 
Hot  stupes,  148. 
Hot-water  bags,  149,  164. 


Insomnia,  68. 


Lamp  shades,  7. 
Light,  6. 

M. 

Malaria,  80,  81. 
Measles,  80,  82. 
Medicines,  36. 

care  to  be  used  in  giving  them, 
37. 

disguising  the  taste,  39. 

measuring,  40. 
Mouth,  care  of,  in  fever,  98. 

wash  for,  76. 
Moving  patient,  18,  119. 
Mumps,  113. 
Mustard  paste,  145. 

making,  145. 

application,  146. 

N. 

Nervous  hysteria,  175. 

Nightgowns,  19. 

Nursing  infectious  fevers,  86. 

care  of  the  room,  13,  91. 

duties  of  the  nurse,  89. 

precautions  for  nurse,  86. 
Nursing  surgical  patients,  166. 

O. 

Observation  of  symptoms,  104. 
Oil-silk  jacket,  147. 
Open  fireplaces,  8,  93. 
Operations  at  home,  158. 

necessary  appliances,  159. 

preparing  the  patient,  166. 

preparing  the  room,  169. 


INDEX 


233 


P. 

Pillows,  3. 

changing  of,  17. 

different  kinds,  4. 

number  of,  3. 
Pills,  40. 
Pleurisy,  56. 
Pneumonia,  56. 
Poisons,  175. 

antidotes,  177. 
Poultices,  143. 

application  of,  144. 

making  of,  144. 
Prescriptions,  41. 
Pulmonary  tuberculosis,  80,  85. 
Pulse,  34. 

R. 

Refrigerators,  15. 
Removing  blood  stains,  14. 
Respiration,  35. 
Room  for  the  sick,  1. 

airing  of,  98,  99. 

arrangement,  2. 

care  of,  13,  91. 

furnishing,  2. 

S. 

Scarlet  fever,  80,  81,  84. 
Screens,  15. 


Shock,  173. 

Sitting  up,  26. 

Sleeping  powders,  39,  6L 

Smallpox,  80-82,  99. 

Sprains,  178. 

Sprays,  162. 

Sterilized  water,  162. 

Sterilized  towels,  162. 
Stings  of  insects,  186. 
St.  Vitus'  dance,  118. 
Support  for  bed-clothes,  21. 
Surgical  bed,  164. 

T. 

Teeth,  77. 

Temperature,  of  the  body,  30. 

of  room,  8. 
Thermometer,  30. 

use  of,  31. 
Tonsilitis,  48. 
Toothache,  184. 
Typhoid  fever,  80,  81,  98. 

V. 

Ventilation,  9. 
Visitors,  23. 
Vomiting,  186. 

W. 

Whooping  cough,  111. 
Wind  colic,  109. 


INDEX   TO   RECEIPTS   FOR   INVALID 
COOKING 


A. 

Apple  charlotte,  221. 
Arrowroot  blanc-mange,  216. 
Arrowroot  jelly,  217. 
Arrowroot  milk,  216. 

B. 

Bacon,  135. 
Banana  cream,  224. 
Barley  water,  208. 
Beef-juice,  132. 
Beef-juice  on  toast,  217. 
Beef  tea,  129. 
Beef-tea  jelly,  208. 
Bill  of  fare  for  one  day,  139. 
Biscuit  soup,  211. 
Blanc-mange,  212. 
Broths,  128. 

C. 

Calf's-foot  broth,  208. 
Celery,  128. 
Chicken  broth,  129. 
Chicken  creamed,  212. 
Chicken  jelly,  216. 
Chicken  pure"e,  212. 
Chopped  beef,  132. 
Coffee,  228. 
Compote  of  fresh  fruit,  125. 


Croutons,  219. 
Custard  boiled,  228. 
Custard  cream,  226. 
Custard  rennet,  220. 
Custard  tapioca,  227. 


D. 


Diet,  120. 


E. 

130. 

Egg  brandy,  220. 
Egg  .caudle,  225. 
Egg  cream,  223. 
Egg  lemonade,  226. 
Egg-nog,  134. 

Eggs  poached  in  broth,  221. 
Eggs  poached  with  cream,  216. 

F. 

Feeding  helpless  patients,  137. 
Fruit,  124. 

G. 

Grape  juice,  209. 
Gruel,  barley,  209. 
Gruel  of  eggs,  210. 
Gruel  of  milk  peptonized,  210. 
Gruel  of  oatmeal,  211. 
Gruel  of  rice,  217. 
234 


INDEX  TO   RECEIPTS 


235 


Irish  moss,  210. 

J. 

Jelly  made  with  prepared  milk, 

219. 
Jelly  of  fresh  fruits,  222. 


Kumiss,  211. 


K. 


L. 


Lemon  jelly,  226. 
Lemon  sherbet,  214. 

M. 

Meat,  minced,  225. 
Meat  soup,  218. 
Milk,  135. 

sterilized,  137. 

peptonized,  136. 
Milk  punch,  133. 
Mutton  broth,  129. 

N. 
Nourishment,  97,  140. 

O. 

Oatmeal  beef  tea,  218. 
Oatmeal  pudding,  219. 
Omelets,  131. 
Orange  and  vichy,  134. 


Oysters  broiled  on  toast,  214. 
Oysters  creamed  on  toast,  220. 
Oysters  scalloped,  224. 
Oyster  stew,  214. 

.-;»  P. 

Panada.  224. 

Preparing  food,  120-128. 

R. 

Raspberry  cream,  227. 
Rice  cakes,  217. 
Rice  cookies,  215. 

S. 

Sago  jelly,  223. 
Sago  soup,  215. 
Sandwiches  of  fruit,  223. 
Savory  eggs,  213. 
Scraped  beef,  131. 
Serving  meals,  125. 
Sweetbreads  baked,  225. 

T. 

Tea  for  invalids,  229. 
Thick  milk,  222. 
Toast,  123. 
Tomatoes,  128. 
Tomato  cream,  222. 
Trays  for  patients,  122. 

W. 
Wine  whey,  134. 


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